The therapeutic efficacy of fenofibrate in nonalcoholic fatty liver disease a meta-analysis of randomized controlled trials

Abstract Objective: To compare the efficacy of fenofibrate therapy in patients with nonalcoholic fatty liver disease (NAFLD) with meta-analysis of randomized controlled trials (RCTs). Method: PubMed, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Wang Fang Database and VIP were searched for clinical trials of fenofibrate therapy in treating patients with NAFLD. The latest search was conducted in December 1, 2020. The quality of included RCTs was assessed with the Cochrane risk of bias tool. The data was extracted and analyzed independently by two researchers. REVIEW MANAGER 5.3 was used to perform meta-analysis STATA 12.0 software was used to conduct publication bias and sensitivity analysis. And the evidence strength was evaluated with the GRADE approach. Result: 12 RCTs with 1272 patients were included. The quality of RCTs was low. The results showed that fenofibrate significantly reduced blood lipid, decreased acute inflammatory damage of liver, and improved the degree of liver fibrosis, but had no effect on insulin resistance. Sensitivity analysis indicated consistent results and there was no significant publication bias. The evidence strength was low. Conclusion: Although fenofibrate shown positive efficacy on blood lipids, liver function and liver fibrosis for patients with NAFLD, more RCTs with high quality are warranted for further evidence because of the low quality of included RCTs.