Efficacy and Safety of a Novel Dietary Supplement, Gepaktiv (International name Phenomenon ), Versus Active Comparators (UDCA and Ademetionine) in Patients with Metabolic-Associated Fatty Liver Disease: A Preliminary Comparative Analysis

Background: Metabolic-associated fatty liver disease (MAFLD) is a prevalent chronic liver condition with limited approved pharmacological treatments [1]. Ursodeoxycholic acid (UDCA) and ademetionine show variable efficacy, primarily on liver enzymes. This study presents a preliminary analysis comparing the efficacy of a novel dietary supplement, Gepaktiv, against these comparators in MAFLD patients. Methods: In this open-label, randomized controlled trial (clinicaltrials.gov NCT07068191 and ITMCTR 2025001469), 19 patients with MAFLD, confirmed by hepatomegaly (liver size >=3 cm above normal by ultrasound), elevated alanine aminotransferase (ALT, 90-150 U/L), and FibroScan results (steatosis >=260 dB/m, fibrosis >=11 kPa), were allocated to Gepaktiv (n=6, 1500 mg/day), UDCA (n=7, 10-15 mg/kg/day), or ademetionine (n=6, 800-1600 mg/day) for 15 days. Patients with significant alcohol consumption (>20 g/day for women, >30 g/day for men) were excluded. Primary outcomes were median changes from baseline to day 15 in ALT, aspartate aminotransferase (AST), liver size (craniocaudal diameter, cm, via ultrasound), steatosis (controlled attenuation parameter, CAP, dB/m), and fibrosis (transient elastography, kPa). Results: Gepaktiv demonstrated median [IQR] reductions of ALT -48.9 [-54.0 to -35.0] U/L, AST -62.8 [-66.0 to -44.0] U/L, liver size -1.9 [-2.0 to -1.2] cm, and steatosis -32.5 [-45.0 to -30.0] dB/m. These reductions were significantly greater compared to both UDCA and Ademetionine groups (p < 0.01 for ALT, AST, and liver size; p < 0.05 for steatosis). Fibrosis reduction was minimal and not statistically significant between groups. Conclusion: Gepaktiv demonstrated greater improvements in biochemical and imaging markers of MAFLD compared to UDCA and ademetionine in this preliminary analysis. These findings warrant further investigation in larger, long-term trials. Note: These preliminary results have not been peer-reviewed and should not guide clinical practice.