Lipids & metabolic liver disease
GLP-1 Receptor Agonists and Risk for Cirrhosis and Related Complications in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease
Main finding · Progression to cirrhosis (patients without cirrhosis)Result — go to the resultHazard ratio 0.86 95% CI 0.75–0.98Authors' conclusion
In this cohort study, GLP-1 RA use was associated with a lower risk of progression to cirrhosis and mortality among patients with MASLD and diabetes. The protective association was not seen in patients with existing cirrhosis, underscoring the importance of treatment earlier in the disease course.
Study context
- Population
- Patients with MASLD and diabetes at 130 Veterans Health Administration hospitals and associated clinics, initiating GLP-1 RA or DPP-4i 2006–2022; analysed separately without (n=14,606 GLP-1 RA users) and with cirrhosis at baselinematched cohort · with 1,452
- Exposure
- GLP-1 RA vs DPP-4i initiation
- GLP-1 RAn = 16,058
- Outcome
- Without cirrhosis: progression to cirrhosis (validated diagnosis codes or noninvasive fibrosis marker); with cirrhosis: composite of cirrhosis complications
Methodological detailsactive comparator, new-user design, propensity score matched 1:1
- Active comparator, new-user design
- Propensity score matched 1:1
Main finding
As reported in the abstract
Progression to cirrhosis (patients without cirrhosis)
Hazard ratio
0.86
95% CI 0.75–0.98
By group
GLP-1 RA
9.98 events per 1000 person-years
DPP-4i
11.10 events per 1000 person-years
GLP-1 RAvs DPP-4i
HR 0.86 (95% CI 0.75–0.98)
Observational data: associations, not effects.
Secondary outcomes
Events per 1000 person-years
| Outcome | GLP-1 RA | DPP-4i | HR (95% CI) | |
|---|---|---|---|---|
| Composite of cirrhosis complications (patients without cirrhosis) | 1.89 | 2.55 | 0.78 (0.59–1.04) | |
| All-cause mortality (patients without cirrhosis) | 21.77 | 24.43 | 0.89 (0.81–0.98) | |
| 0.512Hazard ratio (log scale) |
Original publication
GLP-1 Receptor Agonists and Risk for Cirrhosis and Related Complications in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease. JAMA Intern Med. Published 1 November 2024. doi:10.
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