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.
Expert Rev Gastroenterol Hepatol
; 17(3): 273-282, 2023 Mar.
Article
in En
| MEDLINE
| ID: mdl-36689199
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. [Figure see text].Key words
Full text:
1
Database:
MEDLINE
Main subject:
Diabetes Mellitus, Type 2
/
Non-alcoholic Fatty Liver Disease
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Guideline
/
Systematic_reviews
Language:
En
Journal:
Expert Rev Gastroenterol Hepatol
Year:
2023
Type:
Article
Affiliation country:
China