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The study aimed to investigate if the non-alcoholic fatty liver disease (NAFLD) course is affected by a reduction in levels of serum urate.
In pegloticase treated chronic refractory gout patients, a consistent decrease in serum urate substantially lowered the Fibrosis-4 scores, improved hepatic fibrosis, and thus indicated a plausible effect on the progression of NAFLD.
The study aimed to investigate if the non-alcoholic fatty liver disease (NAFLD) course is affected by a reduction in levels of serum urate.
In this retrospective data analysis, a comparison was done between people with persistent urate-lowering to <1 mg/dL in response to biweekly pegloticase (responders, n=36) with people who were given placebo (n=43). Utilizing the Fibrosis-4 index, NAFLD was evaluated. The groups were compared with the use of 2 sample Wilcoxon tests or regression analysis.
At the baseline, the mean (standard deviation) Fibrosis-4 values were 1.40 (0.86) in pegloticase responders and 1.04 (0.53) in people getting placebo. Over 6 months, a change of 0.26 (0.41) in Fibrosis-4 score was observed in patients receiving placebo. In pegloticase responders, a change of 0.13 (0.62) was seen. A profound difference in the change in the Fibrosis-4 values between pegloticase responders and placebo was noted (-0.15 [0.67] vs. 0.7 [0.42]) when only people with a Fibrosis-4 value >1.3 were taken into consideration (n=27).
The correlation between the serum urate area under the curve (AUC) over the 6-month trial period and the change in Fibrosis-4 value was R=0.33. Multivariable analysis demonstrated that serum urate AUC was the only considerable contributor to the alteration in Fibrosis-4 values.
Hence, the persistent decrease in serum urate indicates a plausible effect on the progression of NAFLD.
Clinical and Experimental Rheumatology
Improvement in hepatic fibrosis estimated by Fibrosis-4 index in pegloticase treated chronic refractory gout patients
Naomi Schlesinger et al.
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