Comparative efficacy of glucagon-like peptide 1 (GLP-1) receptor agonists, pioglitazone and vitamin E for liver histology among patients with nonalcoholic fatty liver disease: systematic review and pilot network meta-analysis of randomized controlled trials. (4th March 2023)

• Record Type: Journal Article
• Authors: Gu, Yunpeng; Sun, Lei; He, Yining; Yang, Luping; Deng, Chaohua; Zhou, Run; Kong, Tingting; Zhang, Wei; Chen, Yutong; Li, Jie; Shi, Junping
• Is Part Of: Expert review of gastroenterology & hepatology. Volume 17:Number 3(2023)
• Page Start: 273
• Page End: 282
• Publication Date: 2023-03-04
• Subjects: Nonalcoholic fatty liver disease -- GLP-1 receptor agonists -- pioglitazone -- vitamin E -- liver histology -- network meta-analysis; Gastroenterology -- Periodicals; Liver -- Diseases -- Periodicals; 616.3
• DOI: 10.1080/17474124.2023.2172397
• Languages: English
• ISSNs: 1747-4124

Abstract

ABSTRACT: Introduction: There is no conclusive evidence comparing the efficacy of glucagon-like peptide 1 (GLP-1) receptor agonists to the other guidelines recommended pharmacotherapy for nonalcoholic fatty liver disease (NAFLD). Therefore, we aim to compare the effects of GLP-1 receptor agonists, pioglitazone and vitamin E in patients with NAFLD. Methods: We searched PubMed, Embase, Web of Science and Cochrane Library up to 11 April 2022. Randomized clinical trials (RCTs) comparing GLP-1 receptor agonists, pioglitazone and vitamin E against placebo or other active controls in patients with NAFLD were included. Results: Nine RCTs including 1482 patients proved eligible. GLP-1 receptor agonists ranked first in steatosis, ballooning necrosis, γ-glutamyl transferase, body weight, body mass index, and triglycerides. Administration of GLP-1 receptor agonists, as compared with placebo, was associated with improvement in liver histology [steatosis (OR = 4.11, 95% CI: 2.83, 5.96), ballooning necrosis (OR = 3.07, 95% CI: 2.14, 4.41), lobular inflammation (OR = 1.86, 95% CI: 1.29, 2.68), fibrosis (OR = 1.52, 95% CI: 1.06, 2.20)]. Conclusions: GLP-1 receptor agonists were as effective as pioglitazone and vitamin E for liver histology among patients with NAFLD. GLP-1 receptor agonists might be considered as an alternative or complementary treatment in the future clinical practice. uf0001