دورية أكاديمية
Glucagon-like peptide-1 receptor agonists and risk of major adverse liver outcomes in patients with chronic liver disease and type 2 diabetes
| العنوان: | Glucagon-like peptide-1 receptor agonists and risk of major adverse liver outcomes in patients with chronic liver disease and type 2 diabetes |
|---|---|
| المؤلفون: | Wester, Axel, Shang, Ying, Toresson Grip, Emilie, Matthews, Anthony A, Hagström, Hannes |
| بيانات النشر: | BMJ Publishing Group Ltd |
| سنة النشر: | 2024 |
| المجموعة: | HighWire Press (Stanford University) |
| مصطلحات موضوعية: | Hepatology |
| الوصف: | Objective Phase II trials suggest glucagon-like peptide-1 receptor (GLP1) agonists resolve metabolic dysfunction-associated steatohepatitis but do not affect fibrosis regression. We aimed to determine the long-term causal effect of GLP1 agonists on the risk of major adverse liver outcomes (MALO) in patients with any chronic liver disease and type 2 diabetes. Design We used observational data from Swedish healthcare registers 2010–2020 to emulate a target trial of GLP1 agonists in eligible patients with chronic liver disease and type 2 diabetes. We used an inverse-probability weighted marginal structural model to compare parametric estimates of 10-year MALO risk (decompensated cirrhosis, hepatocellular carcinoma, liver transplantation or MALO-related death) in initiators of GLP1 agonists with non-initiators. We randomly sampled 5% of the non-initiators to increase computational efficiency. Results GLP1 agonist initiators had a 10-year risk of MALO at 13.3% (42/1026) vs 14.6% in non-initiators (1079/15 633) in intention-to-treat analysis (risk ratio (RR)=0.91, 95% CI=0.50 to 1.32). The corresponding 10-year per-protocol risk estimates were 7.4% (22/1026) and 14.4% (1079/15 633), respectively (RR=0.51, 95% CI=0.14 to 0.88). The per-protocol risk estimates at 6 years were 5.4% (21/1026) vs 9.0% (933/15 633) (RR=0.60, 95% CI=0.29 to 0.90) and at 8 years 7.2% (22/1026) vs 11.7% (1036/15 633) (RR=0.61, 95% CI=0.21 to 1.01). Conclusion In patients with chronic liver disease and type 2 diabetes who adhered to therapy over time, GLP1 agonists may result in lower risk of MALO. This suggests that GLP1 agonists are promising agents to reduce risk of chronic liver disease progression in patients with concurrent type 2 diabetes, although this needs to be corroborated in randomised trials. |
| نوع الوثيقة: | text |
| وصف الملف: | text/html |
| اللغة: | English |
| العلاقة: | http://gut.bmj.com/cgi/content/short/73/5/835Test; http://dx.doi.org/10.1136/gutjnl-2023-330962Test |
| DOI: | 10.1136/gutjnl-2023-330962 |
| الإتاحة: | https://doi.org/10.1136/gutjnl-2023-330962Test http://gut.bmj.com/cgi/content/short/73/5/835Test |
| حقوق: | Copyright (C) 2024, BMJ Publishing Group |
| رقم الانضمام: | edsbas.975D7FF1 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1136/gutjnl-2023-330962 |
|---|