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.
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
Challenge
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.
Solution
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.
Impact
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.
