Lipids & metabolic liver disease
Histological efficacy of anti‐diabetic agents in MASH and the mediating role of weight loss: A network meta‐analysis
Authors' conclusion
SGLT2 inhibitor and incretin-based agents improved fibrosis in MASH, with weight loss being a significant mediator. Targeting multiple incretin pathways, especially involving glucagon receptors, may offer greater MASH resolution. Dose-dependent effects were more prominent for MASH resolution than fibrosis improvement, indicating potential weight-loss-independent anti-fibrotic pathways.
Study context
- Population
- Biopsy-confirmed MASH without cirrhosis
- Participants
- 1,667 participants5 RCTs
- Comparison
- Anti-diabetic agents vs placebo
- Outcome
- Fibrosis improvement (≥1 stage) without worsening steatohepatitis
Methodological detailsfrequentist, random-effects, dose-stratified incretin-based agents, SUCRA ranking, meta-regression
- Frequentist
- Random-effects
- Dose-stratified incretin-based agents
- SUCRA ranking
- Meta-regression
Pooled result
As reported in the abstract
Heterogeneity I2
0%
Further pooled results
MASH resolution without fibrosis worsening
- Heterogeneity I2 (dose-dependent effects)
- 73%
- SUCRA, survodutide (highest ranking)
- 0.822-0.849
- SUCRA, tirzepatide
- 0.622-0.681
- SUCRA, higher-dose semaglutide
- 0.327
- Lower-dose semaglutide showed no benefit
- Dapagliflozin showed benefit in F2-F3 subgroup only on sensitivity analysis
Meta-regression: weight loss explaining heterogeneity in treatment effects
- R2, fibrosis improvement
- 54.26%
- R2, MASH resolution
- 78.16%
- 16 interventions, including placebo arms
Original publication
Histological efficacy of anti‐diabetic agents in MASH and the mediating role of weight loss: A network meta‐analysis. Diabetes Obes Metab. Published 8 October 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →