Journal Article Systematic Review Ppublish 1 citation
PubMed: 39937036 DOI: 10.1111/eci.70003
Pharmacological treatment options for metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes mellitus: A systematic review.
Eur J Clin Invest 55(4):e70003
Authors: Laura A M Konings, Lorena Miguelañez-Matute, Anna M P Boeren, Inge A T van de Luitgaarden, Femme Dirksmeier, Rob J de Knegt, Maarten E Tushuizen, Diederick E Grobbee, Adriaan G Holleboom, Manuel Castro Cabezas
Affiliations
- Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands. Department of Internal Medicine and Endocrinology, Erasmus MC, Rotterdam, the Netherlands.
- Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.
- Julius Clinical, Zeist, the Netherlands.
- Department of Gastroenterology and Hepatology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.
- Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, the Netherlands.
- Department of Gastroenterology and Hepatology, LUMC, Leiden, the Netherlands.
- Department of Internal Medicine, Amsterdam UMC, Amsterdam, the Netherlands.
- Department of Internal Medicine and Endocrinology, Erasmus MC, Rotterdam, the Netherlands.
Abstract
BACKGROUND
Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely related to type 2 diabetes mellitus (T2DM) through a common root in insulin resistance. The more severe stage, metabolic dysfunction-associated steatohepatitis (MASH), increases the risk for cardiovascular complications, liver cirrhosis and hepatocellular carcinoma. Several trials investigating established antidiabetic-drugs in patients with T2DM and MASLD have yielded promising results. Therefore, we aimed to systematically review the effect of T2DM-drug treatment on MALSD parameters.
METHODS
Medical databases were searched until January 2025 for controlled trials in patients with T2DM and MASLD/MASH. Studies that evaluated the effect of T2DM-medication on the severity of MASLD/MASH in T2DM patients were included. The quality of the studies was assessed by three independent reviewers using a set of Cochrane risk-of-bias tools.
RESULTS
Of 1748 references, 117 studies fulfilled the inclusion-criteria and were assessed for eligibility in full-text. Fifty-two articles were included. Data included a total of 64.708 patients and study populations ranged from 9 to 50.742. Heterogeneity in study-design and analysis hampered the comparability of the results. Most evidence was present for GLP-1 receptor agonists, SGLT2-inhibitors and PPAR-γ-agonists for regression of liver fibrosis and MASH.
CONCLUSION
Studies on the value of T2DM-drug treatment in the improvement of MASLD vary significantly in study design, size and quality. GLP-1 receptor agonists, PPAR-γ-agonists, SGLT2-inhibitors may all be preferred pharmacological interventions for patients with MASLD/MASH and T2DM. Newer agents like dual GLP-1/GIP or triple GLP-1/GIP/Glucagon agonists will likely play an important role in the treatment of MASLD/MASH in the near future.
MeSH
Liver Diseases, Diabetes Mellitus, Pharmaceutical Preparations, Non-Alcoholic Fatty Liver Disease, Drug Therapy, Liver, Therapeutics, Diabetes Mellitus, Type 2