Two Medication Classes Reduce CV, Liver Events in Persons with T2D, MASLD: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from 2 analyses presented at ENDO 2024, the Endocrine Society's annual meeting, held June 1-4 in Boston, Massachusetts.

The study

Researchers examined the cardiovascular (CV) and hepatic effectiveness and safety of glucagon-like peptide 1 receptor agonists (GLP-1 RA) and sodium–glucose cotransporter 2 inhibitors (SGLT-2is) in patients with type 2 diabetes (T2D) and known metabolic dysfunction-associated steatotic liver disease (MASLD). They conducted 2 weighted cohort studies in this patient population who initiated therapy with either GLP-1RA (n=13 666), SGLT-2i (n=11 108), or DDP-4i (n=17 084). They used pooled data from Medicare documented between 2013 and 2020 and a large US health insurance database from 2013 to 2022.

The findings

GLP-1RAs and SGLT-2is associated with fewer CV events. Researchers observed that compared with DPP-4i treatment, the HR for the primary CV outcome associated with GLP-1RA agents was 0.67 (95% CI 0.56-0.81), which corresponds to an incidence rate difference (IRD) per 1000 person-years of -21.6 (95% CI 26.7 to -16.6). They also noted CV benefits for SGLT-2i use compared with DPP-4i use, with an HR for the primary CV outcome of 0.82 (95% CI 0.70-0.96) and an IRD of -11 (95% CI -16.2 to -5.8).

GLP-1RAs lowered serious liver events. Investigators noted that GLP-1RAs reduced severe liver events compared to DPP-4is, with an HR for the primary hepatic outcome of 0.47 (95% CI 0.25-0.90) and an IRD of -2.1 (95% CI -3.4 to -0.9). Among the SGLT-2i arm, the HR was 0.81 (95% CI 0.45-1.44) and an IRD of -1.1 (95% CI -2.4 to 0.3).

Authors' comment

"An increasing amount of people live with type 2 diabetes, and a significant proportion of these individuals also struggle with MASLD. Understanding which medications can effectively manage these conditions and prevent severe complications is crucial for their health and quality of life."

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