Comparative effectiveness of sodium‐glucose cotransporter‐2 inhibitors and dipeptidyl peptidase‐4 inhibitors in improvement of fatty liver index in patients with type 2 diabetes mellitus and metabolic dysfunction‐associated steatotic liver disease: A retrospective nationwide claims database study in Japan
Authors' conclusion
SGLT2is use appeared to be associated with a greater improvement of the FLI than DPP4i use in patients with T2DM and MASLD. In the absence of direct head-to-head comparisons from clinical studies, our study, using real-world data, may support physicians' decision-making in clinical practice.
Study context
- Population
- New users of SGLT2i or DPP4i with T2D and MASLD, JMDC Claims Database, Japan
- Participants
- 9,127 vs 12,286
- Exposure
- SGLT2i vs DPP4i
- SGLT2in = 9,127
- DPP4in = 12,286reference
- Outcome
- Incidence of improvement of the fatty liver index (FLI)
Methodological detailsnationwide claims database, new-user design, propensity-score weighted
- Nationwide claims database
- New-user design
- Propensity-score weighted
Main finding
As reported in the abstract
Improvement in FLI (≥30%, ≥40% and ≥50% reduction from baseline)
SGLT2i vs DPP4iWeighted hazard ratio (95% CI)
≥30% reduction
1.27(1.18–1.38)
≥40% reduction
1.24(1.13–1.37)
≥50% reduction
1.19(1.05–1.33)
Observational data: associations, not effects.
Further findings
Time-course change in fatty liver index (FLI) values · up to 3 years
- Greater decrease in FLI values with SGLT2i vs DPP4i up to 3 years of follow-up
Original publication
Comparative effectiveness of sodium‐glucose cotransporter‐2 inhibitors and dipeptidyl peptidase‐4 inhibitors in improvement of fatty liver index in patients with type 2 diabetes mellitus and metabolic dysfunction‐associated steatotic liver disease: A retrospective nationwide claims database study in Japan. Diabetes Obes Metab. Published 6 May 2024. doi:10.
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