SGLT2 inhibitors and the risk of hepatocellular carcinoma in patients with MASLD and Type 2 diabetes
Main finding · HCCResult — go to the resultAdjusted hazard ratio 0.43 95 % CI 0.29–0.63Authors' conclusion
- Among patients with MASLD and T2D, SGLT2 inhibitor use was associated with lower risks of HCC and all-cause mortality compared with active comparators. While residual confounding cannot be excluded, these findings support prospective evaluation of SGLT2 inhibitors for liver-related risk reduction in this population.
Study context
- Population
- Adults aged 18–90 years with non-viral MASLD and pre-existing T2D (2005–2025)propensity-matched
- Participants
- 93,930 vs 93,930
- Exposure
- SGLT2i use vs active comparators
- SGLT2in = 93,930
- Active comparatorsn = 93,930reference
- Outcome
- Hepatocellular carcinoma (HCC) and all-cause mortality
- Follow-up
- Median 3.24 years (IQR 1.72-5.09) SGLT2i; 3.25 years (IQR 1.72-5.08) comparators
Methodological detailsmultinational, TriNetX federated electronic health record network, 1-year washout, active-comparator design, 1:1 propensity score matching
- Multinational
- TriNetX federated electronic health record network
- 1-year washout
- Active-comparator design
- 1:1 propensity score matching
Main finding
HCC
Adjusted hazard ratio
0.43
95 % CI 0.29–0.63
Events by group
SGLT2ivs Active comparators
aHR 0.43 (95 % CI 0.29–0.63)
As reported in the abstract
Observational data: associations, not effects.
Further findings
Liver fibrosis/cirrhosis and hepatic nodules
- Risk reductions were also observed for liver fibrosis/cirrhosis and hepatic nodules
Subgroups and sensitivity analyses
- Results consistent across subgroups and sensitivity analyses, incl. time-anchored landmark analyses
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
SGLT2 inhibitors and the risk of hepatocellular carcinoma in patients with MASLD and Type 2 diabetes. Diabetes Metab. Published 22 August 2025. doi:10.
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