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

被引：27

作者：

Elsaid, Mohamed I. ^{[1
,2
,3
]}

Li, Na ^{[4
]}

Firkins, Stephen A. ^{[5
]}

Rustgi, Vinod K. ^{[6
,7
]}

Paskett, Electra D. ^{[8
,9
]}

Acharya, Chathur ^{[4
]}

Reddy, K. Rajender ^{[10
]}

Chiang, Chien Wei ^{[1
]}

Mumtaz, Khalid ^{[4
,11
]}

机构：

[1] Ohio State Univ, Coll Med, Dept Biomed Informat, Columbus, OH USA

[2] Ohio State Univ, Coll Med, Ctr Biostat, Columbus, OH USA

[3] Ohio State Univ, Coll Med, Dept Internal Med, Div Med Oncol, Columbus, OH USA

[4] Ohio State Univ, Coll Med, Dept Internal Med, Div Gastroenterol Hepatol & Nutr, Columbus, OH USA

[5] Cleveland Clin, Digest Dis & Surg Inst, Cleveland, OH USA

[6] Rutgers Robert Wood Johnson Med Sch, Div Gastroenterol & Hepatol, New Brunswick, NJ USA

[7] Rutgers Robert Wood Johnson Med Sch, Ctr Liver Dis & Masses, New Brunswick, NJ USA

[8] Ohio State Univ, Div Populat Sci, Comprehens Canc Ctr, Columbus, OH USA

[9] Ohio State Univ, Coll Med, Dept Internal Med, Div Canc Prevent & Control, Columbus, OH USA

[10] Univ Penn, Dept Med, Perelman Sch Med, Philadelphia, PA USA

[11] Ohio State Univ, Wexner Med Ctr, Div Gastroenterol Hepatol & Nutr, 395 W 12th Ave, Columbus, OH 43210 USA

来源：

ALIMENTARY PHARMACOLOGY & THERAPEUTICS | 2024年 / 59卷 / 09期

关键词：

adverse liver outcomes; glucagon-like Peptide-1 receptor agonists; hepatic decompensation; overlap propensity score weighting; MELLITUS; STATEMENT; MORTALITY; GLP-1;

D O I：

10.1111/apt.17925

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background/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. In this cohort study, Glucagon-like peptide-1 receptor agonist initiation was associated with significantly lower adverse liver outcomes, including cirrhosis decompensation, portal hypertension, hepatocellular carcinoma, and liver transplantation in patients with metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes.image

引用

页码：1096 / 1110

页数：15

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