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Pioglitazone + ezetimibe is a small molecule combination therapy being developed by Mankind Specialties for the treatment of metabolic dysfunction-associated steatohepatitis (MASH) and metabolic dysfunction-associated steatotic liver disease (MASLD). The combination leverages the repurposed mechanisms of two established drugs: pioglitazone, a peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonist that improves insulin sensitivity and reduces hepatic fat, and ezetimibe, a sterol absorption inhibitor that targets the Niemann-Pick C1-like 1 (NPC1L1) protein to reduce cholesterol uptake. By targeting both metabolic dysfunction and lipid accumulation, the combination aims to provide a synergistic effect in reducing liver inflammation and fibrosis. It is currently in the preclinical stage of development.
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