A 3-month therapy with pemafibrate for 38 NAFLD patients resulted in significant reduction in ALT (63.9 ± 3.6 vs. 41.6 ± 3.6; p < 0.001), which was accompanied by improvements in the NAFLD fibrosis score [(−2.27 ± 0.18) vs. (−2.38 ± 0.18); p = 0.009], but no change in the FIB-4 index was noted (1.51 ± 0.16 vs. 1.47 ± 0.12; p = 0.500). This evidence concerns the gene GPT and metabolic dysfunction-associated steatotic liver disease.