Transient Elastography (Fibroscan) In Monitoring Telmisartan Induced Changes In Liver Fibrosis: Radiological And Histopathological Correlation With Hepatic Stellate Cell Mechanisms

Abstract

Acute and chronic liver illnesses continue to pose a substantial global health challenge, resulting in over 1 million fatalities each year. The purpose of this work is to further investigate and elucidate the underlying mechanisms of hepatic fibrosis and the anti-fibrotic effects of telmisartan with respect to hepatic stellate cell activation, and to report the role and potential imaging changes observed with the use of TE following telmisartan therapy.

Method

This was a prospective, single-center, interventional study involving 120 individuals aged 18–65 years, including 80 with biopsy-confirmed F2–F3 liver fibrosis resulting from non-alcoholic steatohepatitis (NASH). Participants underwent a 24-month treatment intervention consisting of oral telmisartan in conjunction with lifestyle modifications. Forty healthy individuals served as a control group. Biochemical, radiological, and histological assessments were performed at baseline and end of the study. This study included assessing liver stiffness using FibroScan and performing two liver biopsies to evaluate fibrosis stages. SPSS and R software were used for statistical analysis, and results were considered statistically significant at p < 0.05. Treatment adherence and adverse events were closely monitored throughout the trial.

Results

Following 24 months of telmisartan use, significant alterations were seen in comparison to the control group. For instance, ALT decreased from 80.5 to 40.3 U/L, LSM declined from 12.0 to 8.4 kPa, CAP reduced from 291 to 245 dB/m, HbA1c fell from 6.6% to 5.2%, LDL diminished from 142 to 70 mg/dL, and SBP dropped from 134 to 112 mmHg. All of these alterations were statistically significant (p<0.001). Albumin levels increased from 3.49 to 4.20 g/dL, whereas histological markers CPA and α-SMA significantly decreased.

Conclusion

The prescription of Telmisartan resulted in considerable, time-dependent enhancements in liver enzymes, fibrosis, steatosis, and metabolic parameters throughout a 24-month period. Transient elastography provides a non-invasive, quantitative assessment of liver stiffness and serves as a reliable tool for monitoring of fibrosis and the therapeutic response.