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TOPLINE:

The use of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in patients with metabolic dysfunction–associated steatotic liver disease (MASLD) was associated with a reduced risk for new-onset heart failure, composite cardiovascular events, clinically significant portal hypertension events, and all-cause mortality.

METHODOLOGY:

• GLP-1 RAs are a promising treatment option for patients with type 2 diabetes and have cardiovascular benefits, but data on their effect in patients with MASLD are scarce.
• Researchers conducted a retrospective cohort study using the TriNetX database to examine the effects of GLP-1 RAs in adult patients with MASLD or metabolic-associated steatohepatitis (MASH).
• Patients were divided into groups according to whether they received GLP-1 RAs (treatment group) or did not receive GLP-1 RAs after diagnosis (control group).
• The primary outcomes were the incidence or new onset of major adverse cardiovascular events, categorized as heart failure and composite cardiovascular events, as well as clinically significant portal hypertension events; the secondary outcome was all-cause mortality.
• Follow-up assessments were conducted at 1, 3, 5, and 7 years.

TAKEAWAY:

• Researchers identified 634,265 patients, of whom 23,551 received GLP-1 RAs and 610,714 did not.
• After applying propensity score matching to account for confounding variables, 6243 patients each were included in the treatment group (mean age, 55.3 years; 63% women) and the control group (mean age, 55.5 years; 64.5% women).
• At 7 years, the GLP-1 RA group had a significantly lower risk for new-onset heart failure (hazard ratio [HR], 0.72; P < .01), composite cardiovascular events (HR, 0.59; P < .0001), clinically significant portal hypertension events (HR, 0.46; P < .0001), and all-cause mortality (HR, 0.30; P < .0001) than the control group.
• These beneficial effects remained consistent across all timepoints evaluated at 1, 3, 5, and 7 years after the index events.

IN PRACTICE:

"These outcomes underscore the potential clinical value of GLP-1 agonists in MASLD and MASH management," the authors wrote.

SOURCE:

This study was led by Brandon Havranek, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, and published online in Scientific Reports.

LIMITATIONS:

The study relied on electronic medical records for the diagnosis of patients with MASLD without imaging or histologic confirmation, raising the possibility of misdiagnosis. The high proportion of patients with diabetes in the MASLD cohorts made it challenging to distinguish cardiovascular benefits specific to MASLD from those specific to diabetes. The study did not assess outcome differences between various GLP-1 RAs, which could have provided additional insight into their relative effectiveness.

DISCLOSURES:

This study was supported by the Thomas Jefferson University Open Access Fund. One author disclosed serving as a consultant and receiving research grant support from various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.