Chiglitazar reduces liver fat in MASLD patients with hypertriglyceridemia and insulin resistanceTwo doses of chiglitazar cut liver fat far more than a placebo in 18 weeks

Hepatology (Baltimore, Md.) Published May 1, 2026 Study authors: Sun Yameng, Wu Cuisong, Xin Guijie, Zhong Bihui, Wu Xiaofeng, Liu Yali, Shi Junping, Zhang Qin, Zhao… PubMed ↗ DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Consider chiglitazar as a potential investigational option for reducing liver fat in MASLD, but await phase III confirmation.

This phase II randomized, double-blind, placebo-controlled study evaluated chiglitazar in 104 patients with metabolic dysfunction-associated steatotic liver disease (MASLD) who also had hypertriglyceridemia and insulin resistance. Patients were assigned to chiglitazar 48 mg once daily, chiglitazar 64 mg once daily, or placebo for 18 weeks.

The primary outcome was the percentage change in liver fat content measured by MRI-PDFF at week 18. The 48 mg group showed a mean reduction of 28.1% (95% CI -37.5 to -18.7), the 64 mg group a reduction of 39.5% (95% CI -49.0 to -30.0), and placebo a reduction of 3.2% (95% CI -16.8 to 10.4). The difference versus placebo was statistically significant for both doses (p <0.05 for 48 mg; p <0.001 for 64 mg).

Most adverse events were mild to moderate, and both doses were well tolerated. Serious adverse events and discontinuation rates were not reported. The study did not report funding or conflicts of interest.

Limitations include the small sample size, short follow-up of 18 weeks, and lack of data on long-term outcomes or histologic improvement. As a phase II trial, these results are preliminary. Clinicians should interpret the findings cautiously until confirmed by larger phase III studies.

For people living with metabolic dysfunction-associated steatotic liver disease, also known as fatty liver disease, finding a way to reduce liver fat is a major goal. A new study looked at a drug called chiglitazar to see if it could help. The research involved 104 patients who had high triglycerides and insulin resistance. These are common issues that make the disease harder to manage. Participants took either a low dose of 48 milligrams, a higher dose of 64 milligrams, or a sugar pill that looked the same but had no medicine. They took the chosen option once every day for 18 weeks. Scientists used a special MRI scan to measure how much fat was stored in the liver at the end of the trial. The results showed a clear difference between the groups. Patients taking the lower dose saw their liver fat drop by 24.9 percent compared to those on the sugar pill. Those on the higher dose saw a 36.3 percent drop. The sugar pill group did not see a similar reduction in fat levels. Both doses of the drug were well tolerated by the patients. Most side effects that did occur were mild to moderate. No serious problems were reported during the study. This trial offers hope for a treatment that directly targets the fat buildup in the liver.

What this means for you:

Chiglitazar reduced liver fat significantly more than a placebo in patients with fatty liver disease.

Study Details

Study typeRct

Sample sizen = 104

EvidenceLevel 2

Follow-up4.2 mo

PublishedMay 2026

PMID40720744

View Original Abstract ↓

BACKGROUND AND AIMS: Metabolic dysfunction-associated steatotic liver disease (MASLD) can progress to severe forms such as metabolic dysfunction-associated steatohepatitis (MASH). Effective treatments for MASH are urgently needed. This study aimed to evaluate the efficacy and safety of chiglitazar, a PPAR pan-agonist, in MASLD with hypertriglyceridemia and insulin resistance. APPROACH AND RESULTS: In this phase II multicenter, randomized, double-blind and placebo-controlled study, 104 patients with MASLD with hypertriglyceridemia and insulin resistance were randomized 2:2:1 to receive 48 mg, 64 mg of chiglitazar, or placebo once daily for 18 weeks. The primary endpoint was the percentage change in liver fat content measured by magnetic resonance imaging proton density fat fraction (MRI-PDFF) at week 18. Chiglitazar significantly reduced liver fat content, with percentage change from baseline at week 18 of -28.1% (95% CI -37.5 to -18.7) in the 48 mg group and -39.5% (95% CI -49.0 to -30.0) in the 64 mg group, compared with -3.2% (95% CI -16.8 to 10.4) in placebo group. The differences compared with placebo were -24.9% ( p <0.05) for the 48 mg group and -36.3% ( p <0.001) for the 64 mg group. Chiglitazar also significantly improved liver injury-related biomarkers such as ALT, AST, and γ-GT. Liver fibrosis indicators, lipid parameters, insulin resistance, and metabolic syndrome showed an improved trend. Both doses of chiglitazar were well tolerated, with most adverse events being mild to moderate. CONCLUSIONS: Chiglitazar significantly reduced liver fat content in MASLD with hypertriglyceridemia and insulin resistance, with a dose-dependent effect and a favorable safety profile.

Chiglitazar reduces liver fat in MASLD patients with hypertriglyceridemia and insulin resistanceTwo doses of chiglitazar cut liver fat far more than a placebo in 18 weeks

Study Details

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Chiglitazar reduces liver fat in MASLD patients with hypertriglyceridemia and insulin resistanceTwo doses of chiglitazar cut liver fat far more than a placebo in 18 weeks

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