Editors, We read with great interest the studies by El-Kassas and their colleagues [1]. This study provides valuable insights, demonstrating that Lubiprostone is well tolerated and effectively reduces liver fat content in patients with MASLD. However, we wish to highlight a few key considerations to enhance the interpretation of the findings and propose avenues for future research. Firstly, we would like to highlight the significant gender imbalance in the study's patient population.