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GLP-1 RA Use Linked to Reduced Cirrhosis Risk in MASLD, Diabetes

By Elana Gotkine HealthDay Reporter

Medically reviewed by Carmen Pope, BPharm. Last updated on Sep 17, 2024.

via HealthDay

TUESDAY, Sept. 17, 2024 -- For patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and diabetes, glucagon-like peptide 1 receptor agonist (GLP-1 RA) use is associated with a reduced risk for cirrhosis and for cirrhosis complications and mortality, according to a study published online Sept. 16 in JAMA Internal Medicine.

Fasiha Kanwal, M.D., from the Baylor College of Medicine in Houston, and colleagues examined whether GLP-1 RA use is associated with a reduced risk for cirrhosis and its complications among patients with MASLD in a retrospective cohort study with an active comparator. Patients with MASLD and diabetes from 130 Veterans Health Administration hospitals and associated ambulatory clinics who initiated a GLP-1 RA or dipeptidyl peptidase 4 inhibitor (DPP-4i) were included; patients were propensity score-matched in a 1:1 ratio.

Of the 16,058 patients who initiated GLP-1 RAs, 14,606 and 1,452 did not have and did have cirrhosis, respectively. These patients were matched to an equal number of DPP-4i initiators. The researchers found that GLP-1 RA use was associated with a lower risk for cirrhosis compared with DPP-4i use (9.98 versus 11.10 events per 1,000 person-years; hazard ratio, 0.86; 95 percent confidence interval, 0.75 to 0.98) among patients without cirrhosis. Compared with DPP-4i use, GLP-1 RA use was associated with a lower risk for the composite outcome of cirrhosis complications and mortality (hazard ratios [95 percent confidence intervals], 0.78 [0.59 to 1.04] and 0.89 [0.81 to 0.98], respectively). In patients with cirrhosis, there were no associations between GLP-1 RA use and outcomes.

"These results support the need for long-term randomized clinical trials to test the benefits of GLP-1 RA use for primary prevention of cirrhosis in patients with MASLD," the authors write.

Two authors disclosed ties to the biopharmaceutical industry.

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