Lipids & metabolic liver disease
Comparative hepatic effectiveness of empagliflozin vs dapagliflozin among individuals with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease
Authors' conclusion
Among individuals with MASLD, no significant differences were observed between empagliflozin and dapagliflozin in the risk of decompensated hepatic events.
Study context
- Population
- Adults with MASLD (T2D and fatty liver index ≥60) initiating empagliflozin or dapagliflozin, May 2016–December 2023, Korean nationwide claims data; mean age 54.3 years, male 71.3%
- Participants
- 265,098 adults101,487 matched pairs
- Exposure
- Empagliflozin vs dapagliflozin
- Outcome
- FLI-defined MASLD regression (FLI <30) and decompensated hepatic events (ascites, variceal bleeding, hepatic failure, liver transplantation)
Methodological detailsnationwide claims data, new-user design, 1:1 propensity score-matched
- Nationwide claims data
- New-user design
- 1:1 propensity score-matched
Main finding
As reported in the abstract
Empagliflozin vs DapagliflozinHazard ratio (95% CI)
FLI-defined MASLD regression
1.06(1.00–1.11)
Decompensated hepatic events
0.99(0.94–1.03)
Observational data: associations, not effects.
Further findings
Dose-stratified analysis: Fatty liver index (FLI)-defined MASLD regression (FLI <30), empagliflozin vs dapagliflozin
- Low-dose: HR
- 1.19; 95% CI 0.77, 1.83 (95% CI)
- High-dose: HR
- 1.14; 1.01, 1.28 (95% CI)
- Dose-stratified analyses yielded consistent findings
- 1:1 propensity score-matched
Dose-stratified analysis: decompensated hepatic events, empagliflozin vs dapagliflozin
- Low-dose: HR
- 0.95; 0.74, 1.23 (95% CI)
- High-dose: HR
- 1.04; 0.93, 1.15 (95% CI)
- Dose-stratified analyses yielded consistent findings
- 1:1 propensity score-matched
Original publication
Comparative hepatic effectiveness of empagliflozin vs dapagliflozin among individuals with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease. Diabetologia. Published 30 September 2026. doi:10.
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