Shafiq M, Walmann T, Nutalapati V, Gibson C, Zafar Y. Effects of proprotein convertase subtilisin/kexin type-9 inhibitors on fatty liver. World J Hepatol 2020; 12(12): 1258-1167 [PMID: 33442452 DOI: 10.4254/wjh.v12.i12.1258]
Corresponding Author of This Article
Muhammad Shafiq, MD, Assistant Professor, General and Geriatric Medicine, University of Kansas Medical Center, 4000 Cambridge Street, 6040 Delp & Mail Stop 1020, Kansas City, KS 66160, United States. mshafiq@kumc.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Dec 27, 2020; 12(12): 1258-1167 Published online Dec 27, 2020. doi: 10.4254/wjh.v12.i12.1258
Effects of proprotein convertase subtilisin/kexin type-9 inhibitors on fatty liver
Muhammad Shafiq, Timothy Walmann, Venkat Nutalapati, Cheryl Gibson, Yousaf Zafar
Muhammad Shafiq, Cheryl Gibson, General and Geriatric Medicine, University of Kansas Medical Center, Kansas City, KS 66160, United States
Timothy Walmann, Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, KS 66160, United States
Venkat Nutalapati, Department of Gastroenterology, University of Kansas Medical Center, Kansas City, KS 66160, United States
Yousaf Zafar, Internal Medicine, NCH Health Care System, Naples, FL 34102, United States
Author contributions: Shafiq M was involved in all aspects of this study, including but not limited to study design, data collection, and writing of the abstract and manuscript; Walmann T read all the pre- and post-treatment liver imaging scans; Nutalapati V and Zafar Y provided assistance in abstract and manuscript preparation; Gibson C assisted with data analysis.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of University of Kansas Medical Center (Kansas City, KS, United States).
Informed consent statement: In accordance with the retrospective design of the study, based upon chart reviews, no informed consent was required.
Conflict-of-interest statement: The authors declare having no financial relationships to disclose.
Data sharing statement: All relevant data has been provided in this article. No additional data is available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Muhammad Shafiq, MD, Assistant Professor, General and Geriatric Medicine, University of Kansas Medical Center, 4000 Cambridge Street, 6040 Delp & Mail Stop 1020, Kansas City, KS 66160, United States. mshafiq@kumc.edu
Received: June 9, 2020 Peer-review started: June 9, 2020 First decision: September 18, 2020 Revised: October 7, 2020 Accepted: November 12, 2020 Article in press: November 12, 2020 Published online: December 27, 2020 Processing time: 192 Days and 2.8 Hours
ARTICLE HIGHLIGHTS
Research background
Nonalcoholic fatty liver disease (NAFLD) is considered the most common chronic liver disease in the world and can be life-threatening, with some cases progressing to end-stage liver disease. Yet, there is no effective treatment available for it.
Research motivation
Proprotein convertase subtilisin/kexin type-9 (PCSK9) inhibitors have produced favorable effects on liver function in some studies. This prompted our interest in determining whether PCSK9 inhibitors can elicit a therapeutic effect on hepatic steatosis.
Research objectives
Radiologic resolution of hepatic steatosis was the primary outcome, and improvement in liver function biomarkers was the secondary outcome.
Research methods
This study was designed as a retrospective chart review and included the medical records of 29 adult patients (18 years and above in age) who had received PCSK9 inhibitors anytime from January 2015 to July 2019.
Research results
Among the total 29 patients, 11 were found to have radiologic diagnosis of hepatic steatosis. Eight of these eleven patients (72.73%) achieved complete radiologic resolution of hepatic steatosis after using PCSK9 inhibitors for a mean duration of 17.6 mo. Levels of both alanine aminotransferase and aspartate aminotransferase levels also showed a downward trend after use of PCSK9 inhibitors for about 2 years.
Research conclusions
PCSK9 inhibitors can slow down or even result in complete resolution of NAFLD.
Research perspectives
The findings from this study, in conjunction with those from similar studies, can serve as the basis for future prospective research to further explore the effects of PCSK9 inhibitors on hepatic steatosis. PCSK9 inhibitors may represent a significant breakthrough treatment for NAFLD, if prospective studies corroborate the current findings.
