New clinical insights were put forward concerning the appropriate dosing of Pegbelfermin treatment in patients with non-alcoholic steatohepatitis (NASH), a recent dose-response meta-analysis of 4 randomized controlled trials issued in ‘Frontiers in Medicine’ expounded.

A direct relationship exists between the dosage of Pegbelfermin and the decrease in transaminase levels within a specific range, indicating a nonlinear dose-response pattern overall. This implication was based on grey literature and manual searches along with PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov searches, which included relevant trials (4 studies) of Pegbelfermin efficacy in 546 people with NASH. Cochrane Risk of Bias Tool 2.0 was used to estimate the risk of bias and Egger's linear regression for publication bias. Various statistical tests were used to investigate the dose-response relationship. Pegbelfermin at high doses considerably decreased transaminase levels in NASH patients compared to the low-dose Pegbelfermin. A decrease in the transaminase levels was further associated with long-term treatment. Publication bias (p > 0.05) was insignificant.A ‘ceiling effect’ of Pegbelfermin dose on transaminase decline at 30 mg per week and a rebound in transaminase levels after 28 weeks was concluded by Yangguang Lu et al.