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Pemafibrate + tofogliflozin is a combination therapy under clinical development by Kowa Pharmaceuticals for the treatment of metabolic dysfunction-associated steatohepatitis (MASH), formerly known as non-alcoholic steatohepatitis (NASH). The combination consists of pemafibrate, a selective peroxisome proliferator-activated receptor alpha (PPARα) modulator (SPPARMα), and tofogliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor. This dual-action approach aims to address the complex metabolic and hepatic components of MASH by leveraging pemafibrate's ability to improve lipid metabolism and reduce hepatic inflammation alongside tofogliflozin's glucose-lowering and metabolic benefits. Preclinical studies have demonstrated that the combination significantly alleviates hyperglycemia and hypertriglyceridemia while reducing hepatocyte ballooning, a key histological feature of disease progression.
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