However, fibrates have had disappointing results in trials examining their use in NAFLD, with no improvement in histological NASH observed in several pilot studies.47 Moreover, animal studies show that fenofibrate treatment increases hepatic TAG synthesis and hepatic steatosis suggesting an adverse effect of fibrates and PPARα activation in NAFLD.48,49. The gene discussed is PPARA; the disease is metabolic dysfunction-associated steatohepatitis.