Efficacy and safety of GLP-1 receptor agonists in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH): A systematic review and meta-analysis.
Mohammed Alfawaz, Dareen Bajamaan, Lama Alghamdi et al.
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In 30 seconds
This systematic review and random-effects meta-analysis assessed efficacy and safety of GLP-1 receptor agonists in adults with MASLD or MASH. Nine studies involving 795 participants were included. Treatment was associated with reductions in liver fat, body weight, liver enzymes, and HbA1c; the pooled mean difference in liver fat content was -3.17 (95% CI: -4.06 to -2.29). Adverse events, particularly nausea and vomiting, were more frequent with GLP-1 receptor agonists, while serious adverse events did not differ significantly between groups.
Key findings
- Liver fat content decreased with GLP-1 receptor agonists (MD: -3.17; 95% CI: -4.06 to -2.29).
- Pooled reductions were reported for body weight (MD: -4.68; 95% CI: -6.88 to -2.47) and HbA1c (MD: -0.78; 95% CI: -1.07 to -0.49).
- Alanine aminotransferase and aspartate aminotransferase decreased (MD: -15.17; 95% CI: -21.29 to -9.05; and MD: -9.89; 95% CI: -13.65 to -6.13, respectively).
- Adverse events, especially nausea and vomiting, were more frequent; serious adverse events did not differ significantly between groups.
Why it matters
The pooled findings suggest GLP-1 receptor agonists may improve hepatic steatosis alongside weight and glycemic measures in adults with MASLD or MASH. This is clinically relevant given the frequent coexistence of obesity and type 2 diabetes in these populations. However, improvements in these outcomes do not establish effects on fibrosis, histology, or liver-related clinical events.
What to keep in mind
The review included nine studies and 795 participants; the authors call for adequately powered, long-term trials to clarify fibrosis, histological, and liver-related clinical outcomes.