The EXCEL – First-of-its-kind study highlights critical role of essential phospholipids in improving Fatty Liver Disease

PARIS, April 27, 2026 /PRNewswire/ — A new study has established that treatment with essential phospholipids (Essentiale) resulted in a 2.5 times greater reduction in liver fat, significant improvement in fatigue and improvement of glycaemic control in individuals with Metabolic dysfunction–Associated Steatotic Liver Disease (MASLD) – also known as ‘Fatty Liver Disease’ – than diet and exercise alone.

The results were found by the EXCEL clinical trial from Essentiale (an Opella brand) – a multi-centre, randomized, double-blind, placebo-controlled study and the first of its kind to test essential phospholipids (EPLs). The study examined MASLD patients with comorbidities such as type 2 diabetes, hyperlipidaemia, or obesity.

MASLD is the most prevalent chronic liver disease worldwide, affecting an estimated 30% of the adult population, with projections indicating over 55% of adults worldwide will be affected by 2040^[1]. 

Often considered a “silent” condition, fatty liver disease is frequently associated with a debilitating constellation of symptoms such as abdominal pain, fatigue, sleep issues, bloating, depressive symptoms, anxiety and metabolic risks.

Professor Norbert Stefan, Holder of the Chair of Clinical and Experimental Diabetology at the University of Tübingen.
“This groundbreaking research marks an important moment for the millions of people currently living with MASLD. The EXCEL study underscores the clinical importance of early intervention and bridges the gap between scientific evidence and patient experience. By demonstrating measurable improvements in liver fat reduction and improvement of fatigue, this study reinforces the vital message that effective, evidence-based options exist to transform outcomes and restore hope for a more energized life in people with MASLD.”

The EXCEL study used modern, non-invasive imaging to measure liver fat alongside a validated, disease-specific questionnaire to assess the treatment’s impact on patient wellbeing. The main trial results showed that, when used in addition to diet and exercise, essential phospholipids were associated with:

• A 2.5 times greater reduction in liver fat compared with lifestyle intervention alone, as measured by FibroScan CAP (Controlled Attenuation Parameter).
• A statistically significant improvement in patient-reported fatigue, a primary and often overlooked symptom of MASLD. This outcome was formally assessed using the validated CLDQ-MASLD score, a standardized measure of well-being in individuals with chronic liver disease.
• The study also noted that treatment with EPLs significantly reduced HbA1c levels, a key marker for glycemic control in patients with type 2 diabetes, making the findings particularly relevant for the large percentage of MASLD patients with co-existing metabolic conditions.

Nikunj Thakker Global Brand General Manager Essentiale, Opella.
“The EXCEL study proves that timing is everything. When caught early, a significant portion of MASLD cases can be reversible. This evidence-based treatment, using essential phospholipids combined with diet and exercise, actively reduces liver fat and tackles debilitating fatigue head-on, changing outcomes for the billions globally living with Fatty Liver Disease.”

The full study methodology and findings were published in Liver International:
https://onlinelibrary.wiley.com/doi/10.1111/liv.70601.

^[1]  Bellentani S., Scaglioni F., Marino M., and Bedogni G., “Epidemiology of Non–Alcoholic Fatty Liver Disease,” Digestive Diseases 28, no. 1 (2010): 155–161.

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