A retrospective analysis of combination therapy with GLP-1 receptor agonists and SGLT2 inhibitors versus SGLT2 inhibitor monotherapy in patients with MASLD

Aug 12, 2025Nature communications

Comparing combined GLP-1 and SGLT2 treatments to SGLT2 alone in patients with fatty liver disease

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Abstract

Combination therapy with GLP-1 receptor agonists and SGLT2 inhibitors is associated with a lower risk of all-cause hospitalization, mortality, and adverse events for metabolic dysfunction-associated steatotic liver disease.

  • The primary composite outcomes showed a hazard ratio of 0.87 for combination therapy compared to alone.
  • Combination therapy resulted in a 14% reduced risk of all-cause hospitalization (HR, 0.86).
  • All-cause mortality risk was significantly lower with combination therapy, yielding a hazard ratio of 0.45.
  • The risk of major adverse kidney events was reduced with combination therapy (HR, 0.72).
  • Major adverse liver outcomes also showed a reduced risk with combination therapy (HR, 0.61).
  • No additional benefits were observed from combination therapy compared to monotherapy, except for all-cause mortality.

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Key numbers

0.87
Decrease in Primary Composite Outcome Risk
Hazard Ratio for combination therapy vs. monotherapy
0.45
Decrease in All-Cause Mortality Risk
Hazard Ratio for all-cause mortality with combination therapy vs. monotherapy
0.86
Reduction in All-Cause Hospitalization Risk
Hazard Ratio for all-cause hospitalization with combination therapy vs. monotherapy

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