Asthma Drug Formoterol Shows Potential to Reverse MASH and Fatty Liver Disease

Research from the Medical University of South Carolina (MUSC) indicates that formoterol, a widely used medication for asthma and chronic obstructive pulmonary disease (COPD), may be able to reverse damage caused by metabolic dysfunction-associated steatohepatitis (MASH).

MASH is a liver disease that affects hundreds of millions of people globally and is a leading cause of liver transplantation. According to researchers at MUSC, treatment options for the condition currently remain limited.

The findings, published in the Nature partner journal npj Metabolic Health and Disease, suggest that formoterol could offer a new therapeutic pathway for treating the disease. The study found that the medication reversed MASH damage at the functional, ultrastructural, and histologic levels.

Accidental Discovery During Kidney Research

The investigation into the drug’s effect on the liver began unexpectedly during unrelated kidney research. Researchers were originally using mouse models of kidney injury to determine if formoterol could improve damage associated with diabetes.

That initial research was published in the American Journal of Physiology, Renal Physiology in 2024. During those experiments, the research team noticed that the mice receiving the drug also appeared to have less liver fat.

Kind of unexpectedly, we found that the liver damage also reversed, said Joshua Lipschutz, M.D., Division director of Nephrology and the Arthur Williams Endowed Chair in Nephrology at MUSC.

This observation prompted a second line of research specifically focused on the liver to determine if the beta-2 pathway could influence metabolic disease across multiple organs.

Study Methodology and Results

To test the drug’s impact on liver health, the research team utilized a mouse model with a high-fat diet designed to mimic the conditions of MASH. The follow-up study associated the treatment with formoterol with the reversal of the fatty liver.

The study was authored by Joshua Lipschutz, M.D., in collaboration with Don Rockey, M.D., and Jessica Hartman, Ph.D. The research also included co-first authors Kristina Stayer, a Ph.D. Student from the Hartman Lab, and Brennan Winkler, a Ph.D. Student from the Lipschutz Lab.

Clinical Significance of Formoterol

Formoterol is a beta-2 adrenergic receptor agonist that has been prescribed for decades to open airways for patients with respiratory conditions. Because it is already an established medication, it has a well-established safety profile.

Researchers note that this existing safety record could significantly accelerate the path toward further development and testing if the metabolic effects observed in mice are confirmed in human patients.