In our original sensitivity analysis of 72 patients who underwent paired liver biopsies, we found that aspirin use was associated with 36% lower odds of developing incident advanced fibrosis, after accounting for age, sex, baseline fibrosis stage, and time between paired biopsies (adjusted odds ratio, 0.64; 95% confidence interval, 0.50-0.80). Importantly, further accounting for time-varying BMI did not materially impact this strong, inverse association (adjusted odds ratio, 0.67; 95% confidence interval, 0.53-0.89). Together with other recent studies of aspirin in liver disease, 2,3 our work offers an opportunity to reflect on priorities and targets for future research. We eagerly anticipate future prospective studies that will validate our findings in larger populations with long-term follow-up for both clinical and histological outcomes. Such efforts will help to more robustly characterize the potential benefits and hazards of aspirin use in patients with NAFLD, across the full spectrum of disease.
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