Two common heart medicines may reverse fatty liver disease and cut heart risks, study suggests

Two medicines available in your local pharmacy could hold the answer to a condition that harms many. Scientists in Barcelona believe they may have found just that. In a study that harks back to the golden age of drug repurposing, two well-known medications — pemafibrate and telmisartan — appear to work wonders in reducing liver fat and preventing complications from metabolic liver disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is no stranger to modern life, one in three adults may be living with it, often unaware. It develops when too much fat gathers in the liver, raising the stakes for serious liver damage and deadly heart disease. Current treatment options? Scant. But a study published in Pharmacological Researchsuggests that pairing these two familiar drugs could change everything.

Instead of crafting risky new pills from scratch, researchers led by Marta Alegret at the University of Barcelona turned to a clever approach: drug repurposing. Since both drugs are already approved — one for cholesterol (pemafibrate), the other for blood pressure (telmisartan) — they’ve passed safety hurdles. That makes them ideal candidates to treat early-stage MASLD, when the disease is still reversible and symptoms are few.

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Here are the findings from rats to zebrafish:

• In rats, the drug combo cut liver fat as effectively as a full dose of one drug alone.


• Zebrafish larvae, used as a simpler model, showed similar benefits.


• The combo also lowered blood pressure and cholesterol, a double win.


• Each drug works differently: telmisartan restores PCK1 protein levels, shifting fat metabolism.


• Crucially, the combo could reduce side effects by allowing lower doses of each drug.

Nevertheless, these results come from animal studies, and human trials will be essential before anything changes at the pharmacy. Researchers are now exploring how the combo holds up in more advanced disease, where scarring of the liver (fibrosis) begins to set in. Still, the promise is there: two familiar names, repurposed with purpose, could be the future of liver care.