Use of sodium-glucose transport protein 2 inhibitors and dipeptidyl peptidase 4 inhibitors in patients with MASLD in a real-world setting is associated with lower all-cause mortality

While GLP-1 RAs had attracted the most attention in MASLD, SGLT2 inhibitors and DPP4 inhibitors—also widely used in the T2D population—had received less study in terms of their real-world association with liver-relevant outcomes, leaving a gap in the comparative effectiveness evidence for metabolic-class drugs in MASLD.

The TARGET-NASH cohort was used to identify MASLD patients using SGLT2 or DPP4 inhibitors for ≥1 year and compare their all-cause mortality to non-users, with multivariable Cox models adjusting for baseline characteristics.

Demonstrating lower all-cause mortality associated with SGLT2 and DPP4 inhibitor use in real-world MASLD patients provides comparative effectiveness evidence relevant to the expanding landscape of metabolic drug development for MASH and supports the regulatory context for these agents' use in liver disease.

SGLT2/DPP4 inhibitor real-world effectiveness analysis in MASLD, Metabolic drug comparative effectiveness benchmarking for MASH development landscape, Real-world mortality outcome analysis supporting repositioning of diabetes medications in liver disease