Effects of GLP-1 receptor agonists on the degree of liver fibrosis and CRP in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: A systematic review and meta-analysis

Mar 30, 2024Primary care diabetes

GLP-1 receptor agonists and their impact on liver scarring and inflammation in fatty liver disease and fatty liver inflammation

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Abstract

A meta-analysis of 16 randomized controlled trials involving 2178 patients indicates that glucagon-like peptide-1 receptor agonists (GLP-1RAs) significantly improve histologic resolution of NASH without worsening liver fibrosis.

GLP-1RAs demonstrated a significant effect on histologic resolution of NASH, with a weighted mean difference of 4.08 (95% CI 2.54-6.56).
The analysis included trials that measured outcomes using liver biopsy or imaging techniques.
GLP-1RAs also significantly improved C-reactive protein (CRP) levels, with a weighted mean difference of -0.41 (95% CI -0.78 to -0.04).
Other serological indicators showed significant improvement with GLP-1RAs as well.
The findings are based on data from trials involving liraglutide, exenatide, dulaglutide, or semaglutide.

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BACKGROUND: Based on the rapidly growing global burden of non-alcoholic fatty liver disease (NAFLD) or steatohepatitis (NASH), in order to evaluate the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in the treatment of NAFLD or NASH this paper presents a systematic review and meta-analysis of randomized controlled trials(RCTs).

METHODS: In this systematic review and meta-analysis, We searched PubMed, Medline, Web of Science and The Cochrane Library databases. All randomized controlled trials involving GLP-1RAs and NAFLD or NASH were collected since the database was established. A meta-analysis of proportions was done with the generalised linear mixed model. Continuous variables were represented by Mean and Standard Deviation (SD), and binary variable were represented by Relative Risk (RR) and 95% Confidence Interval (CI) as effect indicators. The research results were presented by Revman 5.4. This study is registered with PROSPERO (CRD42023390735).

FINDING: We included 16 placebo-controlled or active drug-controlled randomized controlled trials (involving 2178 patients) that used liraglutide, exenatide, dulaglutide, or semaglutie in the treatment of NAFLD or NASH, as measured by liver biopsy or imaging techniques. This study found that the effect of GLP-1RAs on histologic resolution of NASH with no worsening of liver fibrosis (n=2 RCTs; WMD:4.08, 95%CI 2.54-6.56, p < 0.00001) has statistically significant. At the same time, GLP-1RAs affected CRP (n = 7 RCTs; WMD:-0.41, 95% CI-0.78 to -0.04, p =0.002) and other serological indicators were significantly improved.

CONCLUSION: This study evaluated the efficacy of GLP-1RAs in patients with NAFLD and NASH. These results suggest that GLP-1RAs may be a potential and viable therapeutic approach as a targeted agent to intervene in disease progression of NAFLD and NASH.

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Effects of GLP-1 receptor agonists on the degree of liver fibrosis and CRP in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: A systematic review and meta-analysis

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