Comparative effectiveness of GLP ‐1 receptor agonists, SGLT2 inhibitors and DPP ‐4 inhibitors on liver outcomes in metabolic dysfunction‐associated steatotic liver disease: A retrospective cohort study
Authors' conclusion
In this large real-world study, we found no clear or consistent differences in liver-related outcomes across GLP-1RA, SGLT2i, and DPP-4i users over a 2-year period.
Study context
- Population
- Patients with MASLD and T2D initiating GLP-1 RA, SGLT2i or DPP-4i, US healthcare claims databases3 propensity score (PS)-matched cohorts
- Exposure
- GLP-1 RA vs SGLT2i vs DPP-4i
- Outcome
- Cumulative incidence of cirrhosis or HCC
- Follow-up
- 2 years
Methodological detailspropensity-score matched, US healthcare claims databases
- Propensity-score matched
- US healthcare claims databases
Main finding
As reported in the abstract
Cirrhosis or HCC
Hazard ratio (95% CI)
GLP-1RAvs DPP-4i4538 matched pairs
0.80(0.58–1.09)
GLP-1RAvs SGLT2i4754 matched pairs
0.76(0.55–1.04)
SGLT2ivs DPP-4i4333 matched pairs
0.78(0.58–1.05)
Observational data: associations, not effects.
Original publication
Comparative effectiveness of GLP ‐1 receptor agonists, SGLT2 inhibitors and DPP ‐4 inhibitors on liver outcomes in metabolic dysfunction‐associated steatotic liver disease: A retrospective cohort study. Diabetes Obes Metab. Published 21 January 2026. doi:10.
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