Aspirin for Patients with Nonalcoholic Fatty Liver Disease

One of the key predictors of increased liver-related morbidity and mortality in patients with nonalcoholic fatty liver disease (NAFLD) is the development and progression of liver fibrosis. Recent studies have shown that aspirin may have antifibrotic effects in NAFLD. In murine models, aspirin limits hepatic stellate cell activation by inhibiting the cyclooxygenase-2 (COX-2) enzyme, and antagonism of COX-2 seems to improve nonalcoholic steatohepatitis (NASH)–related fibrosis. In humans, much of the literature has been limited to cross-sectional studies.

Now, investigators have conducted a prospective cohort study involving 361 adults with biopsy-proven NAFLD, 151 of whom were daily aspirin users. Participants underwent evaluation every 3 to 1…