GLP-1 RA and Reduced Liver and Non-Liver Complications in Adults with T2D and MASLD: A Target Trial Emulation Study

• DOI: 10.3350/cmh.2024.1096
• Publication Date: 2025-04-23T23:56:24Z
• Authors: Xianhua Mao; Xinrong Zhang; Rongtao Lai; Ka-Shing Cheung; Man-Fung Yuen; Ramsey Cheung; Wai-Kay Seto; Mindie H Nguyen

Information about the association of glucagon-like peptidase 1 receptor agonist (GLP-1RA) with liver and non-liver complications is insufficient in patients type 2 diabetes (T2D) metabolic dysfunction-associated steatotic disease (MASLD). We conducted a target trial emulation study to evaluate whether GLP-1RA decreases risk outcomes. Patients T2D MASLD initiating or dipeptidyl peptidase-4 inhibitor (DPP-4i) were included from 2013 2022 Merative™ Marketscan® Research Databases. Primary outcomes (1) hepatocellular carcinoma (HCC) cirrhosis, (2) cardiovascular (CVD), chronic kidney (CKD), cancer. Inverse probability treatment weighting was applied balance baseline characteristics Cox regression models estimate hazard ratio (HR) 95% confidence interval (CI). In intention-to-treat design, GLP-1RA, compared DPP-4i, had significantly lower incidence (per 1000 person-years) HCC (0.8 vs 1.7; HR 0.53, 95%CI 0.39-0.71), cirrhosis (29.3 32.9; 0.91, 0.86-0.96), CVD (57.2 73.9; 0.90, 0.86-0.95), CKD (4.5 6.8; 0.73, 0.64-0.84), cancer (16.9 22.9; 0.82, 0.77-0.89). per-protocol significant inverse associations for these still observed, 0.60-0.77. this emulated nationwide MASLD, use, when associated complications.