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Living with Fatty Liver and NASH

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PPar (say pee par) possibly the next drug to be approved for MASH

nash2 profile image
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fattyliverfoundation.org/la...

PPAR -- Peroxisome proliferator-activated receptor

Lanifibranor by Inventiva leads the way

Wayne, you must be crazy to think I'll read something that starts out like that!!!

Be calm, I promise, it will make sense and if liver disease interests you this will be worth your time.

Therapies for MASLD/MASH have been an elusive target and recent history is littered with promising molecules that many thought were finally going to lead to treatments for our disease. This is not a trivial problem. People are dying and our weapons are coffee and vitamin E. We have recently had the welcome approval of Rezdiffra for F2/F3 patients but we still have a long way to go to have effective therapy for the wide range of liver patients.

Don't get on me about lifestyle right now. I know that tune but I also connect through our peer groups with thousands of people who need more than that and drugs will be part of a proper management of this disease if we can find effective drugs that work.

So what is it with PPARs? OK, a tiny bit of biology. Cells are complicated and there are a lot of chemical things happening that make life possible. We all know that DNA and genes are the foundations of life but without some way to cause chemical reactions to happen DNA is nothing but a dumb string that hangs around like your worthless brother in law.

It isn't quite this simple but the PPARs are a class of proteins that connect to DNA and cause the genes to do something. There are 3 main types of PPARs and they exist in most cell types and play a critical role in what happens inside that cell. Because they affect so many things and regulate some of the most important functions it makes sense to think that if we can manage them we can help cells remain healthy.

I am particularly interested in Lanifibranor because most of the molecules being studied are focused on just one or two of the three types of PPAR and we have seen that this can lead to unwanted side effects. Conceptually if you could have very precise control of specific chemistries you could have the precision medicine people dream of. Perhaps one day, but we really don't know how to balance all of the processes that are happening in cells.

The three families of PPARs are related and overlap in function but of the drugs currently in trial only Lanifibranor shares function with all three. With our limited knowledge today, we think this approach has a chance to succeed with fewer side effects and as patients those side effects are a big deal.

One more thing, if you have a chance to participate in a clinical trial for one of these drugs, please volunteer. We will continue to die slowly and in pain from the complications of fibrosis when lifestyle change alone doesn't get us to a healthy place. That can't change until the research has been done so come to the party if you get a chance.

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Alterity profile image
Alterity

I'm on the research list at Ohio State Wexner and hope to start my 3rd research in January or sometime after the first of the year. If I can save lives after I'm gone great. Also excited to go to the Convention in a few weeks. Still kicking after 23 years of living in moderation for everything and listen to my body. But there are days as we all have.

nash2 profile image
nash2Partner in reply toAlterity

What a great attitude, thank you

Golendoodle profile image
Golendoodle

When will know if this drug get approved? I was not able to take resdiffera because of side effects.

nash2 profile image
nash2Partner in reply toGolendoodle

If they are successful, approval would be likely in 2026. Nothing moves fast with these drug approvals

Golendoodle profile image
Golendoodle

Hi Wayne I was looking up some information regarding this drug lanifibanor and I wanted to know if they are excluding those with thyroid issues from the trial?

nash2 profile image
nash2Partner in reply toGolendoodle

I don't think thyroid is a disqualifier

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