PPARA and Hepatic fibrosis: It has been reported that pemafibrate has beneficial effects on hepatic function with a lower frequency of hepatic impairment than other PPARα agonists (48, 49) and that pemafibrate decreases markers of liver dysfunction including ALT and γGT and markers of liver fibrosis including FIB-4 index and the AST to platelet ratio index (50–57).