GLP-1 Agonists Help 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:
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Population-based cohort study using data from the National Health Insurance Research Database of Taiwan.
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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.
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All-cause mortality, cardiovascular events, decompensated cirrhosis, and other key outcomes were compared using multivariable-adjusted Cox proportional hazards models.
TAKEAWAY:
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During mean follow-up of about 3 years, rates of death per 1000 person-years were 27.5 in GLP-1 RA users versus 55.9 in nonusers.
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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).
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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 conclude.
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.
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