Hepatic Events Prevention by Antihyperglycemic Therapies and Intervention Comparisons in Type 2 Diabetes: The HEPATIC-T2DM Network Meta-analysis
Authors' conclusion
Liver-specific risk reduction is not uniform across antihyperglycemic drug classes. Randomized trials are needed to determine whether these associations reflect true drug effects.
Study context
- Population
- Adults with T2DM
- Participants
- 7,124,845 adults46 observational studies
- Comparison
- Glucose-lowering drug classes compared for major adverse liver outcomes (MALOs)
- Outcome
- Major adverse liver outcomes (MALOs)
Methodological detailsthree-level Bayesian, study- and database-level random effects, SUCRA ranking, PubMed, EMBASE and Cochrane CENTRAL searched December 1946 through 23 August 2025
- Three-level Bayesian
- Study- and database-level random effects
- SUCRA ranking
- PubMed, EMBASE and Cochrane CENTRAL searched December 1946 through 23 August 2025
Pooled result
As reported in the abstract
Hepatocellular carcinoma incidence
HR
- TZD vs DPP-4i
- 0.50
- TZD vs GLP-1RAs
- 0.72
- TZD vs Insulin
- 0.20
- TZD vs Sulfonylureas
- 0.69
Further pooled results
| Outcome | HR |
|---|---|
| CirrhosisSGLT2i vs DPP-4i | 0.66 |
| CirrhosisSGLT2i vs GLP-1RAs | 0.66 |
Decompensation (composite)
- GLP-1RAs lowest hazard vs all other classes (hazard ratios (HRs) 0.16-0.91; all significant)
Cirrhosis
- SGLT2i least associated with cirrhosis
Variceal bleeding, hepatic encephalopathy and liver-related mortality
- GLP-1RAs least associated with variceal bleeding and hepatic encephalopathy
- SGLT2i least associated with liver-related mortality
Original publication
Hepatic Events Prevention by Antihyperglycemic Therapies and Intervention Comparisons in Type 2 Diabetes: The HEPATIC-T2DM Network Meta-analysis. Diabetes Care. Published 13 April 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →