Dulaglutide effectively treats early NAFLD with diabetes, find Indian researchers
Haryana, India: Dulaglutide when included in standard type 2 diabetes (T2D) treatment helps in significant reduction of liver fat in patients with type 2 diabetes and NAFLD, according to a recent study in the journal Diabetologia. This means that the GLP agonist Dulaglutide can be considered for the early treatment of NAFLD in T2D patients.
Liraglutide is a daily injectable glucagon-like peptide-1 receptor (GLP-1r) agonist that has been shown to reduce liver fat content (LFC) in humans. However, there is a scarcity of data regarding the effect of dulaglutide, a once-weekly GLP-1r agonist, on human LFC. The study by Mohammad S. Kuchay, Division of Endocrinology and Diabetes, Medanta–The Medicity Hospital, Haryana, India, and colleagues
This study examined the effect of dulaglutide on LFC in individuals with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD).
For the purpose, the researchers conducted a 24 week, open-label, parallel-group, randomised controlled trial called Effect of dulaglutide on liver fat (D-LIFT) to determine the effect of dulaglutide on liver fat at a tertiary care centre in India.
64 patients with type 2 diabetes and MRI-derived proton density fat fraction-assessed LFC of ≥6.0% at baseline were included. They were randomly randomly assigned to receive dulaglutide weekly for 24 weeks (add-on to usual care) or usual care, based on a predefined computer-generated number with a 1:1 allocation that was concealed using serially numbered, opaque, sealed envelopes.
The primary endpoint was the difference of the change in LFC from 0 (baseline) to 24 weeks between groups.
Key findings of the study include:
- 52 participants were included for per-protocol analysis: those who had MRI-PDFF data at baseline and week 24.
- Dulaglutide treatment resulted in a control-corrected absolute change in LFC of −3.5% and relative change of −26.4%, corresponding to a 2.6-fold greater reduction.
- Dulaglutide-treated participants also showed a significant reduction in γ-glutamyl transpeptidase (GGT) levels (mean between-group difference −13.1 U/l) and non-significant reductions in aspartate aminotransferase (AST) (−9.3 U/l and alanine aminotransferase (ALT) levels (−13.1 U/l).
- Absolute changes in PFC (−1.4%) and LSM (−1.31 kPa) were not significant when comparing the two groups.
- There were no serious drug-related adverse events.
"When included in the standard treatment for type 2 diabetes, dulaglutide significantly reduces LFC and improves GGT levels in participants with NAFLD. There were non-significant reductions in PFC, liver stiffness, serum AST and serum ALT levels," concluded the authors.
The study, "Effect of dulaglutide on liver fat in patients with type 2 diabetes and NAFLD: randomised controlled trial (D-LIFT trial)," is published in the journal Diabetologia.
DOI: https://link.springer.com/article/10.1007/s00125-020-05265-7
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