Patterns of Medication Use Among Adult Patients with Elevated Serum ALT Levels in Patients with NAFLD: TARGET-NASH.

Challenge

Polypharmacy in NAFLD is common and poses DDI risk, but the specific patterns of medication use associated with elevated ALT—and the clustering of medication classes within disease severity strata—had not been characterized using unsupervised methods in a large real-world cohort.

Solution

The TARGET-NASH registry was analyzed using hierarchical cluster analysis to identify distinct medication use patterns within NAFLD cirrhosis, NASH, and NAFL patient groups, with odds ratios for ALT elevation by medication class calculated using forward stepwise regression.

Impact

Identifying medication clusters associated with elevated ALT in NAFLD patients provides actionable safety surveillance intelligence for drug developers designing concomitant medication policies and informs the selection of DDI-sensitive medication categories for exclusion or monitoring in NAFLD trials.