Retrospective cohort study shows reduced liver fibrosis progression in MASLD with type 2 diabetes using combination therapy, suggesting effective treatment options.
Key Points
To compare the effectiveness of GLP-1RA plus SGLT2i versus GLP-1RA alone on liver fibrosis progression in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM).
Conducted a retrospective cohort study using Mass General Brigham healthcare network data (2010–2024).
Included adults with MASLD and T2DM starting GLP-1RA therapy with baseline FIB-4 scores indicating low or intermediate risk.
Defined combination therapy as concurrent SGLT2i use for at least 50% of the GLP-1RA treatment period.
Used propensity score matching (1:2) to minimize confounding.
Combination therapy users had a significantly lower risk of fibrosis progression (3.10 vs. 4.01 per 100 person-years; HR 0.76, 95% CI 0.61–0.95).
Numerically lower incidence of hepatic complications was observed in combination therapy (1.05 vs. 1.34 per 100 person-years; HR 0.76, 95% CI 0.53–1.09).
Subgroup analyses showed significant benefits for patients with a BMI ≤35.