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