Aspirin Reduces Liver Fat in Clinical Trial of the Most Common Cause of Chronic Liver Disease

The most common chronic liver disease—called metabolic dysfunction–associated steatotic liver disease (MASLD)—is characterized by an increased buildup of fat in the liver due to factors such as obesity and type 2 diabetes.

Such elevated fat poses serious health risks, but a recent clinical trial published in JAMA and conducted by investigators from Massachusetts General Hospital, a founding member of the Mass General Brigham healthcare system, reveals that daily aspirin can significantly reduce liver fat content.

“Since MASLD is estimated to affect up to a third of U.S. adults, aspirin represents an attractive potential low-cost option to prevent progression to cirrhosis or liver cancer, the most feared complications of MASLD,” said senior author Andrew T. Chan, MD, MPH, a gastroenterologist and chief of the Clinical and Translational Epidemiology Unit at Massachusetts General Hospital.

Chan and his colleagues tested aspirin’s potential because the drug reduces inflammation and affects fat metabolism.

In their phase 2 trial, 80 adults with MASLD were randomized to receive daily low-dose aspirin (81 mg) or placebo for six months.

At the end of the trial, the average change in liver fat content was -6.6% with aspirin versus +3.6% with placebo, indicating that low-dose aspirin reduced the average liver fat content by 10.2% compared with placebo. Low-dose aspirin was found to be safe and well-tolerated.

Aspirin also improved various markers of liver health. “Multiple non-invasive blood and imaging-based tests for liver fat, inflammation, and fibrosis all showed a similar direction of benefit that favored aspirin treatment,” said lead author and Principal Investigator Tracey G. Simon, MD, MPH, a hepatologist in the Division of Gastroenterology at Massachusetts General Hospital. “Together, these data support the potential for aspirin to provide benefits for patients with MASLD.”

Additional studies are needed to determine whether continued aspirin use can reduce individuals’ risk of long-term health complications associated with MASLD.

Authorship: Tracey G. Simon, MD, MPH; Robert M. Wilechansky, MD; Stefania Stoyanova, BA; Alessandra Grossman, BA; Laura E. Dichtel, MD, MHS; George M. Lauer, MD, PhD; Karan K. Miller, MD; Yujin Hoshida, MD, PhD; Kathleen E. Corey, MD, MPH, MMSc; Rohit Loomba, MD, MHSc; Raymond T. Chung, MD; and Andrew T. Chan, MD, MPH .

Funding: This work was supported by K23DK122107 and R35 CA253185***.

About Massachusetts General Hospital

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. MGH is a founding member of the Mass General Brigham healthcare system.