RESEARCHERS have discovered that the use of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is associated with a significant reduction in the risk of developing cirrhosis and its complications.
The research team investigated whether GLP-1 RAs are associated with a reduced incidence of cirrhosis and related complications in patients with MASLD and diabetes, compared to dipeptidyl peptidase 4 inhibitors (DPP-4i). They conducted a retrospective cohort study with patients from 130 Veterans Health Administration hospitals who initiated either GLP-1 RAs or DPP-4i therapy between 2006 and 2022. Participants with MASLD and diabetes were divided into two groups: those with cirrhosis at baseline and those without. Propensity score matching was used to ensure comparable patient groups. Among the 14,606 patients without cirrhosis, GLP-1 RA use was associated with a lower risk of cirrhosis (hazard ratio [HR]: 0.86; 95% CI: 0.75-0.98) and lower all-cause mortality (HR: 0.89; 95% CI: 0.81-0.98). However, for the 1,452 patients with pre-existing cirrhosis, no significant benefit was observed in preventing further complications or mortality.
The findings suggest that GLP-1 RAs could play a preventive role in reducing the risk of cirrhosis and related complications in patients with MASLD and diabetes, especially when initiated early in the disease course. Future clinical trials are needed to confirm these results and explore the potential for GLP-1 RAs in broader MASLD management strategies.
Katrina Thornber, EMJ
Reference
Kanwal F et al. GLP-1 receptor agonists and risk for cirrhosis and related complications in patients with metabolic dysfunction-associated steatotic liver disease. JAMA Intern Med. 2024;DOI:10.1001/jamainternmed.2024.466.
