Latest News

GLP-1 agonists offer multiple benefits in type 2 diabetes with liver cirrhosis


 

Topline

Glucagon-like peptide-1 receptor agonist (GLP-1 RA) use lowers the risk for death, cardiovascular disease, decompensated cirrhosis, and liver failure in adults with type 2 diabetes (T2D) and compensated liver cirrhosis, new observational data show.

Methodology

  • Population-based cohort study using data from the National Health Insurance Research Database of Taiwan.
  • Propensity-score matching was used to construct 467 matched pairs of GLP-1 RA users and nonusers (mean age, 57) with T2D and compensated liver cirrhosis.
  • All-cause mortality, cardiovascular events, decompensated cirrhosis, and other key outcomes were compared using multivariable-adjusted Cox proportional hazards models.

Takeaway

  • During mean follow-up of about 3 years, rates of death per 1,000 person-years were 27.5 in GLP-1 RA users versus 55.9 in nonusers.
  • GLP-1 RA users had a significantly lower risk for mortality (adjusted hazard ratio [aHR], 0.47), cardiovascular events (aHR, 0.6), decompensated cirrhosis (aHR, 0.7), hepatic encephalopathy (aHR, 0.59), and liver failure (aHR, 0.54).
  • A longer cumulative duration of GLP-1 RA use was associated with lower risk for these outcomes compared with no use.

In practice

“GLP-1 RAs may be a treatment option for diabetes patients with liver cirrhosis. However, additional studies are needed to confirm our results and to explore the mechanisms of GLP-1 RAs, cirrhotic decompensation and hepatic encephalopathy,” the researchers concluded.

Study details

The study was led by Fu-Shun Yen, Dr Yen’s Clinic, Taoyuan, Taiwan. It was published online June 16, 2023, in Clinical Gastroenterology and Hepatology. Funding was provided in part by the Taiwan Ministry of Health and Welfare Clinical Trial Center, China Medical University Hospital, Taipei Veterans General Hospital, and the Ministry of Science and Technology.

Limitations

Limitations of the study include a lack of complete information on family history, diet, body weight, and physical activity, as well as biochemical tests, hemoglobin A1c, pathology, and imaging findings that could potentially influence the results.

Disclosures

The authors disclosed no relevant financial relationships.

A version of this article originally appeared on Medscape.com.

Recommended Reading

SAFE algorithm detects liver disease in general population
MDedge Internal Medicine
ADA: Screen all with type 2 diabetes for fatty liver disease
MDedge Internal Medicine
Once-weekly basal insulin nears market for type 2 diabetes
MDedge Internal Medicine
FDA OKs pancreatic islet cell therapy for type 1 diabetes
MDedge Internal Medicine
Beta cells from stem cells: Nearing a cure for type 1 diabetes?
MDedge Internal Medicine
Tirzepatide: Therapeutic titan or costly cure?
MDedge Internal Medicine
WHO plans to declare common sweetener as possible carcinogen
MDedge Internal Medicine
Thirty-three percent of type 1 diabetes patients insulin free with stem cells
MDedge Internal Medicine
COORDINATE-Diabetes: A ‘wake-up call’ for many specialties
MDedge Internal Medicine
Education before Ramadan key to safe fasting with diabetes
MDedge Internal Medicine