Impacts of glucagon‐like peptide‐1 receptor agonists on the risk of adverse liver outcomes in patients with metabolic dysfunction‐associated steatotic liver disease cirrhosis and type 2 diabetes

Mohamed I. Elsaid; Na Li; Stephen A. Firkins; Vinod K. Rustgi; Electra D. Paskett; Chathur Acharya; K. Rajender Reddy; Chien Wei Chiang; Khalid Mumtaz

doi:10.1111/apt.17925

journal article Open Access Mar 27, 2024

Impacts of glucagon‐like peptide‐1 receptor agonists on the risk of adverse liver outcomes in patients with metabolic dysfunction‐associated steatotic liver disease cirrhosis and type 2 diabetes

Mohamed I. Elsaid

Chathur Acharya K. Rajender Reddy

Chien Wei Chiang Khalid Mumtaz

Alimentary Pharmacology & Therapeutics Vol. 59 No. 9 pp. 1096-1110 · Wiley

View at Publisher Save 10.1111/apt.17925

Abstract

SummaryBackground/AimsWe examined the effects of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) initiation on long‐term Adverse Liver Outcomes (ALO) in patients with Metabolic Dysfunction‐Associated Steatotic Liver Disease (MASLD) cirrhosis and type 2 diabetes using real‐world data from the MarketScan database.MethodsWe conducted a retrospective cohort study of patients with MASLD cirrhosis and type 2 diabetes between 2012 and 2020. Cox proportional hazard models examine the association between GLP‐1RAs initiation, modelled as time‐dependent, and the risk of ALO, a composite endpoint defined by the first occurrence of hepatic decompensation(s), portal hypertension, hepatocellular carcinoma (HCC) or liver transplantation (LT). We used Overlap Propensity Score Weighting (OPSW) to account for confounding. The study included 459 GLP‐1RAs and 4837 non‐GLP‐1RAs patients.ResultsThe non‐GLP‐1RAs patients presented with 1411 (29%) ALO over 7431.7 person years, while GLP‐1RAs patients had 32 (7%) ALO over 586.6 person years – risk rate difference 13.5 (95% CI: 11.4–15.7) per 100 person‐years. The OPSW‐adjusted risk of ALO was reduced by 36% (hazard ratio [HR]: 0.64; 95% CI: 0.54–0.76) in patients with vs. without GLP‐1RAs initiation. GLP‐1RAs initiation was associated with significant reductions in the adjusted risk of hepatic decompensation (HR: 0.74; 95% CI: 0.61–0.88), portal hypertension (HR: 0.73; 95% CI: 0.60–0.88), HCC (HR: 0.37; 95% CI: 0.20–0.63) and LT (HR: 0.24; 95% CI: 0.12–0.43).ConclusionThe use of GLP‐1RAs was associated with significant risk reductions in long‐term adverse liver outcomes, including hepatic decompensation, portal hypertension, HCC and LT, in MASLD cirrhosis patients with type 2 diabetes.

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Details

Published: Mar 27, 2024
Vol/Issue: 59(9)
Pages: 1096-1110
License: View

Authors

M

Mohamed I. Elsaid

Department of Biomedical Informatics College of Medicine, The Ohio State University Columbus Ohio USA; Center for Biostatistics College of Medicine, The Ohio State University Columbus Ohio USA; Department of Internal Medicine, Division of Medical Oncology College of Medicine, The Ohio State University Columbus Ohio USA

N

Na Li

Department of Internal Medicine, Division of Gastroenterology, Hepatology & Nutrition College of Medicine, The Ohio State University Columbus Ohio USA

S

Stephen A. Firkins

Digestive Disease and Surgery Institute, Cleveland Clinic Cleveland Ohio USA

V

Vinod K. Rustgi

Division of Gastroenterology and Hepatology Rutgers Robert Wood Johnson Medical School New Brunswick New Jersey USA; Center for Liver Diseases and Masses Rutgers Robert Wood Johnson Medical School New Brunswick New Jersey USA

E

Electra D. Paskett

Division of Population Sciences The Ohio State University Comprehensive Cancer Center Columbus Ohio USA; Department of Internal Medicine, Division of Cancer Prevention and Control College of Medicine, The Ohio State University Columbus Ohio USA

C

Chathur Acharya

Department of Internal Medicine, Division of Gastroenterology, Hepatology & Nutrition College of Medicine, The Ohio State University Columbus Ohio USA

K

K. Rajender Reddy

Department of Medicine University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA

C

Chien Wei Chiang

Department of Biomedical Informatics College of Medicine, The Ohio State University Columbus Ohio USA

K

Khalid Mumtaz

Department of Internal Medicine, Division of Gastroenterology, Hepatology & Nutrition College of Medicine, The Ohio State University Columbus Ohio USA

Funding

National Cancer Institute Award: P30CA016058

National Center for Advancing Translational Sciences Award: UL1TR002733

Cite This Article

Mohamed I. Elsaid, Na Li, Stephen A. Firkins, et al. (2024). Impacts of glucagon‐like peptide‐1 receptor agonists on the risk of adverse liver outcomes in patients with metabolic dysfunction‐associated steatotic liver disease cirrhosis and type 2 diabetes. Alimentary Pharmacology & Therapeutics, 59(9), 1096-1110. https://doi.org/10.1111/apt.17925

Impacts of glucagon‐like peptide‐1 receptor agonists on the risk of adverse liver outcomes in patients with metabolic dysfunction‐associated steatotic liver disease cirrhosis and type 2 diabetes

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