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Comparison of glucagon-like peptide-1 receptor agonists and thiazolidinediones on treating nonalcoholic fatty liver disease: A network meta-analysis

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Background/Aims: Previous studies have revealed that glucagon-like peptide-1 receptor agonist (GLP-1RA) and thiazolidinedione (TZD) can improve nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH). However, comprehensive research comparing the effects of GLP-1RA and TZD is limited. Thus, this study aimed to compare the effects of GLP-1RA and TZD on NAFLD or NASH through a network meta-analysis. Methods: The PubMed, Embase, Web of Science, and Scopus databases were searched for randomized controlled trials (RCTs) that explored the efficacy of GLP-1RAs or TZDs in adult patients with NAFLD or NASH. The outcomes were liver biopsy-based (NAFLD activity score [NAS], fibrosis stage, and NASH resolution), noninvasive technique-based (liver fat content on proton magnetic resonance spectroscopy [1H-MRS] and controlled attenuation parameter [CAP]), biological, and anthropometric indicators. A random effects model was used to calculate the mean difference (MD) and relative risk with 95% confidence interval (CI). Results: Twenty-five RCTs with 2,237 overweight or obese patients were included. GLP-1RA was significantly superior in reducing liver fat content evaluated using 1H-MRS (MD -2.42, 95% CI -3.84 to -1.00), body mass index (MD -1.60, 95% CI -2.41 to -0.80), and waist circumference (MD -4.89, 95% CI -8.17 to -1.61) than TZD. In liver biopsy-based evaluation and liver fat content assessment using CAP, GLP-1RA tended to surpass TZD, albeit not significantly. Sensitivity analysis showed consistent results with the main results. Conclusions: Compared with TZD, GLP-1RA had better effects on liver fat content, body mass index, and waist circumference in overweight or obese patients with NAFLD or NASH.

Abstract

Background/Aims: Previous studies have revealed that glucagon-like peptide-1 receptor agonist (GLP-1RA) and thiazolidinedione (TZD) can improve nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH). However, comprehensive research comparing the effects of GLP-1RA and TZD is limited. Thus, this study aimed to compare the effects of GLP-1RA and TZD on NAFLD or NASH through a network meta-analysis. Methods: The PubMed, Embase, Web of Science, and Scopus databases were searched for randomized controlled trials (RCTs) that explored the efficacy of GLP-1RAs or TZDs in adult patients with NAFLD or NASH. The outcomes were liver biopsy-based (NAFLD activity score [NAS], fibrosis stage, and NASH resolution), noninvasive technique-based (liver fat content on proton magnetic resonance spectroscopy [1H-MRS] and controlled attenuation parameter [CAP]), biological, and anthropometric indicators. A random effects model was used to calculate the mean difference (MD) and relative risk with 95% confidence interval (CI). Results: Twenty-five RCTs with 2,237 overweight or obese patients were included. GLP-1RA was significantly superior in reducing liver fat content evaluated using 1H-MRS (MD -2.42, 95% CI -3.84 to -1.00), body mass index (MD -1.60, 95% CI -2.41 to -0.80), and waist circumference (MD -4.89, 95% CI -8.17 to -1.61) than TZD. In liver biopsy-based evaluation and liver fat content assessment using CAP, GLP-1RA tended to surpass TZD, albeit not significantly. Sensitivity analysis showed consistent results with the main results. Conclusions: Compared with TZD, GLP-1RA had better effects on liver fat content, body mass index, and waist circumference in overweight or obese patients with NAFLD or NASH.

참고문헌 (49)

  1. 이병완, "Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus: A Position Statement of the Fatty Liver Research Group of the Korean Diabetes Association", Diabetes and Metabolism Journal, 44(3), pp.382~401 (2020), 대한당뇨병학회
  2. Younossi ZM, "Global epidemiology of nonalcoholic fatty liver disease-Metaanalytic assessment of prevalence, incidence, and outcomes", Hepatology, 64, pp.73~84 (2016)
  3. Hashimoto E, "Characteristics and diagnosis of NAFLD", NASH, 2013, pp.28(Suppl 4), 64~70
  4. Younossi Z, "Nonalcoholic steatohepatitis is the fastest growing cause of hepatocellular carcinoma in liver transplant candidates", Clin Gastroenterol Hepatol, 17, pp.748~755 (2019)
  5. Targher G, "Nonalcoholic fatty liver disease and chronic vascular complications of diabetes mellitus", Nat Rev Endocrinol, 14, pp.99~114 (2018)
  6. Younossi Z, "Global burden of NAFLD and NASH : trends, predictions, risk factors and prevention", Nat Rev Gastroenterol Hepatol, 15, pp.11~20 (2018)
  7. Sanyal AJ, "NASH : A global health problem", Hepatol Res, 41, pp.670~674 (2011)
  8. Lazarus JV, "Advancing the global public health agenda for NAFLD: a consensus statement", Nat Rev Gastroenterol Hepatol, 19, pp.60~78 (2022)
  9. Sheka AC, "Nonalcoholic steatohepatitis : A review", JAMA, 323, pp.1175~1183 (2020)
  10. Zhu Y, "Efficacy and safety of GLP-1 receptor agonists in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease: A systematic review and meta-analysis", Front Endocrinol(Lausanne), 12, pp.769069~ (2021)
  11. Sanyal AJ, "Past, present and future perspectivesin nonalcoholic fatty liver disease", Nat Rev Gastroenterol Hepatol, 16, pp.377~386 (2019)
  12. Uygun A, "Metformin in the treatment of patients with non-alcoholic steatohepatitis", Aliment Pharmacol Ther, 19, pp.537~544 (2004)
  13. Lavine JE, "Effect of vitamin E or metformin for treatment of nonalcoholic fatty liver disease in children and adolescents:the TONIC randomized controlled trial", JAMA, 305, pp.1659~1668 (2011)
  14. Haukeland JW, "Metformin in patients with nonalcoholic fatty liver disease : a randomized, controlled trial", Scand J Gastroenterol, 44, pp.853~860 (2009)
  15. Idilman R, "Clinical trial : insulin-sensitizing agents may reduce consequences of insulin resistance in individuals with nonalcoholic steatohepatitis", Aliment Pharmacol Ther, 28, pp.200~208 (2008)
  16. Shields WW, "The effect of metformin and standard therapy versus standard therapy alone in nondiabetic patients with insulin resistance and nonalcoholic steatohepatitis(NASH) : A pilot trial", Therap Adv Gastroenterol, 2, pp.157~163 (2009)
  17. Musso G, "A meta-analysis of randomized trials for the treatment of nonalcoholic fatty liver disease", Hepatology, 52, pp.79~104 (2010)
  18. Musso G, "Thiazolidinediones and advanced liver fibrosis in nonalcoholic steatohepatitis : A meta-analysis", JAMA Intern Med, 177, pp.633~640 (2017)
  19. Sanyal AJ, "Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis", N Engl J Med, 362, pp.1675~1685 (2010)
  20. Armstrong MJ, "Liraglutide safety and efficacy in patients with nonalcoholic steatohepatitis(LEAN) : a multicentre, doubleblind, randomised, placebo-controlled phase 2 study", Lancet, 387, pp.679~690 (2016)
  21. Yan J, "Liraglutide, sitagliptin, and insulin glargine added to metformin : The effect on body weight and intrahepatic lipid in patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease", Hepatology, 69, pp.2414~2426 (2019)
  22. Newsome PN, "A placebo-controlled trial of subcutaneous semaglutide in nonalcoholic steatohepatitis", N Engl J Med, 384, pp.1113~1124 (2021)
  23. Ding C, "Sodiumglucose cotransporter protein-2 inhibitors and glucagon-like peptide-1 receptor agonists versus thiazolidinediones for nonalcoholic fatty liver disease : A network meta-analysis", Acta Diabetol, 59, pp.519~533 (2022)
  24. Kovalic AJ, "Pharmacotherapeutic impact on nonalcoholic steatohepatitis histology : A systematic review and network metaanalysis", J Clin Exp Hepatol, 12, pp.1057~1068 (2022)
  25. Luo Q, "Efficacy of off-label therapy for non-alcoholic fatty liver disease in improving noninvasive and invasive biomarkers: A systematic review and network meta-analysis of randomized controlled trials", Front Med(Lausanne), 9, pp.793203~ (2022)
  26. Pennisi G, "Effect of pharmacological interventions and placebo on liver Histology in nonalcoholic steatohepatitis : A network metaanalysis", Nutr Metab Cardiovasc Dis, 32, pp.2279~2288 (2022)
  27. Yan H, "GLP-1 RAs and SGLT2 inhibitors for insulin resistance in nonalcoholic fatty liver disease: Systematic review and network meta-analysis", Front Endocrinol(Lausanne), 13, pp.923606~ (2022)
  28. Hutton B, "The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions : checklist and explanations", Ann Intern Med, 162, pp.777~784 (2015)
  29. Kleiner DE, "Design and validation of a histologicalscoring system for nonalcoholic fatty liver disease", Hepatology, 41, pp.1313~1321 (2005)
  30. Wan X, "Estimating the sample mean and standard deviation from the sample size, median, range and", or interquartile range, 2014, pp.14, 135~
  31. Higgins JP, "Meta-analysis of skewed data : combining results reported on log-transformed or raw scales", Stat Med, 27, pp.6072~6092 (2008)
  32. "Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021)"[URL]
  33. Sterne JAC, "RoB 2 : a revised tool for assessing risk of bias in randomised trials", BMJ, 366, pp.l4898~ (2019)
  34. Rücker G, "Ranking treatments in frequentist network meta-analysis works without resampling methods", BMC Med Res Methodol, 15, pp.58~ (2015)
  35. Hoaglin DC, "Conducting indirect-treatment-comparison and network-meta-analysis studies : report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices : part 2", Value Health, 14, pp.429~437 (2011)
  36. Chalasani N, "The diagnosis and management of nonalcoholic fatty liver disease : Practice guidance from the American Association for the Study of Liver Diseases", Hepatology, 67, pp.328~357 (2018)
  37. Cusi K, "American Association of Clinical Endocrinology Clinical Practice Guideline for the diagnosis and management of nonalcoholic fatty liver disease in primary care and endocrinology clinical settings : Co-sponsored by the American Association for the Study of Liver Diseases(AASLD)", Endocr Pract, 28, pp.528~562 (2022)
  38. Sridharan K, "Pharmacological interventions for non-alcoholic fatty liver disease : a systematic review and network meta-analysis", Postgrad Med J, 94, pp.556~565 (2018)
  39. Lian J, "Efficacy of various hypoglycemic agents in the treatment of patients with nonalcoholic liver disease with or without diabetes A network meta-analysis", Front Endocrinol(Lausanne), 12, pp.649018~ (2021)
  40. Singh S, "Comparative effectiveness of pharmacological interventions for nonalcoholic steatohepatitis : A systematic review and network metaanalysis", Hepatology, 62, pp.1417~1432 (2015)
  41. Majzoub AM, "Systematic review with network meta-analysis : comparative efficacy of pharmacologic therapies for fibrosis improvement and resolution of NASH", Aliment Pharmacol Ther, 54, pp.880~889 (2021)
  42. Panunzi S, "Pioglitazone and bariatric surgery are the most effective treatments for non-alcoholic steatohepatitis : A hierarchical network meta-analysis", Diabetes Obes Metab, 23, pp.980~990 (2021)
  43. Jalili R, "The evaluation of effective drugs for the treatment of non-alcoholic fatty liver disease : A systematic review and network meta-analysis", Adv Pharm Bull, 10, pp.542~555 (2020)
  44. Bernsmeier C, "Glucose-induced glucagon-like Peptide 1secretion is deficient in patients with non-alcoholic fatty liver disease", PLoS One, 9, pp.e87488~ (2014)
  45. Maselli DB, "Effects of GLP-1 and its analogs on gastric physiology in diabetes mellitus and obesity", Adv Exp Med Biol, 1307, pp.171~192 (2021)
  46. Drucker DJ, "The incretin system : glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes", Lancet, 368, pp.1696~1705 (2006)
  47. Fan H, "Exenatide improves type 2 diabetes concomitant with non-alcoholic fatty liver disease", Arq Bras Endocrinol Metabol, 57, pp.702~708 (2013)
  48. Liu Q, "Liraglutide modulates gut microbiome and attenuates nonalcoholic fatty liver in db", db mice, 2020, pp.261, 118457~
  49. Yang M, "Liraglutide attenuates non-alcoholic fatty liver disease in mice by regulating the local renin-angiotensin system", Front Pharmacol, 11, pp.432~ (2020)

관련 논문AI추천

Reply to correspondence on “Comparison of glucagonlike peptide-1 receptor agonists and thiazolidinediones on treating nonalcoholic fatty liver disease: a network meta-analysis”Jian-Gao Fan, Mohammed Eslam, Tian-Yi Ren대한간학회 · Clinical and Molecular Hepatology2024 · 제30권 제4호Old and new classes of glucose-lowering agents as treatments for non-alcoholic fatty liver disease: A narrative reviewChristopher D Byrne, Giovanni Targher, Jing Xu, Lei Miao, Ming-Hua Zheng대한간학회 · Clinical and Molecular Hepatology2022 · 제28권 제4호Incretin-based therapy in the management of metabolic dysfunction-associated steatotic liver disease (MASLD): one piece of the puzzle: Editorial on “Comparison of glucagon-like peptide-1 receptor agonists and thiazolidinediones on treating nonalcoholic fatty liver disease: A network meta-analysis”Jian-Gao Fan, Mohammed Eslam, Tian-Yi Ren대한간학회 · Clinical and Molecular Hepatology2024 · 제30권 제4호Correspondence to editorial on “Comparison of glucagon-like peptide-1 receptor agonists and thiazolidinediones on treating nonalcoholic fatty liver disease: a network meta-analysis”Hayeon Kim, Kyungim Kim, Min Jeong Park, Myeong Gyu Kim대한간학회 · Clinical and Molecular Hepatology2024 · 제30권 제4호Beneficial effect of anti-diabetic drugs for nonalcoholic fatty liver diseaseByung-Wan Lee, Kyung-Soo Kim대한간학회 · Clinical and Molecular Hepatology2020 · 제26권 제4호Pharmacological advances in the treatment of nonalcoholic fatty liver diseases : focused on global results of randomized controlled trials손주현, Jihyun An대한간학회 · Clinical and Molecular Hepatology2023 · 제29권 제2호

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