Lipids & metabolic liver disease
Efficacy of Initiation of Semaglutide versus SGLT2 Inhibitors in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Multicenter Propensity-Matched Real-World Study
Authors' conclusion
In this large real-world MASLD cohort, initiating semaglutide was linked to potential reductions in mortality, hospitalization, and adverse cardiometabolic, liver, and kidney outcomes compared to SGLT2is.
Study context
- Population
- Adults with MASLD and at least one metabolic comorbidity, excluding alternative exposures and confounding liver etiologies55,525 matched per cohort
- Participants
- 128,332 vs 100,542
- Exposure
- Semaglutide vs SGLT2i initiation
- Semaglutiden = 128,332
- SGLT2isn = 100,542reference
- Outcome
- All-cause mortality, hospitalization, MACE, major adverse liver outcomes
- Follow-up
- 1 year
Methodological detailsmulticenter, propensity score-matched, TriNetX U.S. Collaborative Network
- Multicenter
- Propensity score-matched
- TriNetX U.S. Collaborative Network
Main finding
As reported in the abstract
Estimate (95% CI)
Between Semaglutide and SGLT2is
HR (all-cause mortality) 0.382(0.338–0.430)
Between Semaglutide and SGLT2is
HR (all-cause hospitalization) 0.444(0.429–0.459)
Between Semaglutide and SGLT2is
HR (MACE) 0.502(0.476–0.530)
Between Semaglutide and SGLT2is
HR (major adverse liver outcomes) 0.361(0.316–0.412)
Observational data: associations, not effects.
Further findings
All-cause mortality, all-cause hospitalization, MACE and major adverse liver outcomes · 5 years
- HR all-cause mortality
- 0.494 (95% CI 0.459-0.531)
- HR all-cause hospitalization
- 0.565 (95% CI 0.551-0.579)
- HR MACE
- 0.584 (95% CI 0.560-0.609)
- HR major adverse liver outcomes
- 0.494 (95% CI 0.452-0.540)
- Corresponding hazard ratios (HRs) to the 1-year analysis
Major adverse kidney events · 1 year
- No difference; HR
- 0.998
Major adverse kidney events · 5 years
- Reduction; HR
- 0.858 (95% CI 0.789-0.933)
Individual liver events (ascites, hepatic failure)
- Followed similar patterns
Original publication
Efficacy of Initiation of Semaglutide versus SGLT2 Inhibitors in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Multicenter Propensity-Matched Real-World Study. Endocr Pract. Published 19 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →