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Liraglutide in patients with non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trials - 11/12/20

Doi : 10.1016/j.clinre.2020.10.012 
Maria-Styliani Kalogirou a, Dimitrios Patoulias b, , Anna-Bettina Haidich c, Evangelos Akriviadis a, Emmanouil Sinakos a
a Fourth Department of Internal Medicine, Aristotle University of Thessaloniki, General Hospital “Hippokration”, Greece 
b Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, General Hospital “Hippokration”, Greece 
c Department of Hygiene, Social and Preventive Medicine and Medical Statistics, Medical School, Aristotle University of Thessaloniki, Greece 

Corresponding author at: Second Propedeutic Department of Internal Medicine, General Hospital “Hippokration”, Konstantinoupoleos 49, 54642, Thessaloniki, Thessaloniki, Greece.Second Propedeutic Department of Internal MedicineGeneral Hospital “Hippokration”Konstantinoupoleos 49, 54642, ThessalonikiThessalonikiGreece
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 11 December 2020

Highlights

NAFLD represents the most common chronic liver disease, closely related to several co-morbidities.
No licensed pharmacotherapy exists so far.
GLP-1RAs constitute a class of antidiabetics, exerting multiple, pleiotropic effects.
Few RCTs have assessed the safety and efficacy of liraglutide as a treatment option in NAFLD.
The present meta-analysis confirms that liraglutide does not affect significantly hepatic fat content.

Le texte complet de cet article est disponible en PDF.

Abstract

Background

A few randomized controlled trials (RCTs) have assessed the use of liraglutide as a treatment option in patients with non-alcoholic fatty liver disease (NAFLD). We aimed at critically appraising and summarizing these RCTs, providing precise effect estimates regarding the safety and efficacy of liraglutide in NAFLD.

Methods

We searched major databases and grey literature from their inception to May 2019, for RCTs comparing liraglutide with placebo or active comparator in patients with NAFLD. We defined as primary efficacy outcomes the observed changes in hepatic fat content (HFC) and alanine aminotransferase levels (ALT). Metabolic outcomes of interest and major safety endpoints were also assessed.

Results

We included five trials with 371 randomised participants in total. Liraglutide produced a non-significant decrease in HFC and ALT levels, compared to control. It induced a significant reduction in body mass index, primarily driven by reduction in patients with type 2 diabetes, while it did not affect significantly glycated hemoglobin levels and Homeostatic Model Assessment of Insulin Resistance. We also showed that liraglutide significantly decreased serum triglyceride levels, also driven by the observed reduction in patients with type 2 diabetes, however it did not significantly affect the rest lipid parameters. Liraglutide was associated with increased incidence of gastrointestinal adverse events, while, no other safety issues were identified.

Conclusion

Our results do not substantiate the use of liraglutide in patients with NAFLD yet, despite its promising role.

Le texte complet de cet article est disponible en PDF.

Abbreviations : RCT, NAFLD, NASH, ALT, HFC, BMI, HOMA-IR, HbA1c, HCC, IR, DNL, T2DM, AASLD, EASL, SGLT-2, GLP-1 RA, PRISMA, CT, 1H-MRS, MRI, TG, TC, LDL-C, HDL-C, MD, CI, RR, SD, SE, GGT, AST, DPP-4, MRI-PDFF

Keywords : Liraglutide, Non-alcoholic fatty liver disease, Non-alcoholic steatohepatitis, Intrahepatic fat, Alanine aminotransferase


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© 2020  Publié par Elsevier Masson SAS.
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