Comparative efficacy of glucagon-like peptide 1 (GLP-1) receptor agonists, pioglitazone and vitamin E for liver histology among patients with nonalcoholic fatty liver disease: systematic review and pilot network meta-analysis of randomized controlled trials

Jan 23, 2023Expert review of gastroenterology & hepatology

How GLP-1 drugs, pioglitazone, and vitamin E compare in improving liver tissue in people with nonalcoholic fatty liver disease

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Abstract

Nine randomized clinical trials involving 1482 patients demonstrated the effectiveness of GLP-1 receptor agonists in treating nonalcoholic fatty liver disease (NAFLD).

  • GLP-1 receptor agonists showed the highest ranking in improving steatosis, ballooning necrosis, liver enzyme levels, body weight, body mass index, and triglycerides.
  • Compared to placebo, GLP-1 receptor agonists were associated with significant improvements in liver histology, including steatosis, ballooning necrosis, lobular inflammation, and fibrosis.
  • The odds ratios for liver histology improvements with GLP-1 receptor agonists were 4.11 for steatosis, 3.07 for ballooning necrosis, 1.86 for lobular inflammation, and 1.52 for fibrosis.
  • GLP-1 receptor agonists were found to be as effective as pioglitazone and vitamin E in improving liver histology among patients with NAFLD.

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