Published online Jan 15, 2021. doi: 10.4239/wjd.v12.i1.84
Peer-review started: September 21, 2020
First decision: November 16, 2020
Revised: November 22, 2020
Accepted: December 2, 2020
Article in press: December 2, 2020
Published online: January 15, 2021
The efficacy of novel glucose-lowering drugs in treating non-alcoholic fatty liver disease (NAFLD) is unknown.
Although accumulated evidence suggests that these novel glucose-lowering drugs are promising in the treatment of NAFLD and nonalcoholic steatohepatitis, there is conflicting evidence and no convincing consensus on their long-term efficacy and outcome. In addition, there have been few head-to-head clinical trials comparing these novel glucose-lowering drugs directly.
We carried out this meta-analysis to evaluate the efficacy of novel glucose-lowering drugs in treating NAFLD.
Electronic databases were systematically searched. The inclusion criteria were: Randomized controlled trials comparing dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), or sodium-glucose cotransporter 2 (SGLT2) inhibitors against placebo or other active glucose-lowering drugs in NAFLD patients, with outcomes of changes in liver enzyme [alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST)] from baseline.
Treatment with DPP-4 inhibitors, GLP-1 RAs, and SGLT2 inhibitors resulted in improvements in serum ALT and AST levels. The trends of reduction in magnetic resonance imaging proton density fat fraction and visceral fat area changes were also observed in the DPP-4 inhibitor, GLP-1 RA, and SGLT2 inhibitor treatment groups.
Treatment with DPP-4 inhibitors, GLP-1 RAs, and SGLT2 inhibitors resulted in improvements in serum ALT and AST levels and body fat composition, indicating a beneficial effect in improving liver injury and reducing liver fat in NAFLD patients.
In this meta-analysis, we made a comprehensive evaluation of the efficacy of novel glucose-lowering drugs in treating NAFLD.