SGLT2 inhibitors improve FIB-4 index better than pioglitazone in MAFLD patients

The study points are:

• 95 patients were treated with SGLT2i
• 86 patients were treated with pioglitazone.
• Twenty-nine patients were treated with both.
• The primary outcome measured was the change in fibrosis (FIB)-4 index between baseline and 96 weeks.
• There was a significant decrease at 96 weeks in the mean FIB-4 index in the SGLT2i group. This was not recorded in the pioglitazone group.
• In both the groups, there was a decrease in aspartate aminotransferase to platelet ratio index (APRI), serum aspartate and alanine aminotransferase (ALT), haemoglobin A1c, and fasting blood sugar significantly decreased in both groups.
• The ALT in the SGLT2i group and pioglitazone was -17 ± 3 IU/L and -14 ± 3 IU/L, respectively.
• The body weight decreased in the SGLT2i group and increased in the pioglitazone group increased.
• As per baseline ALT (>30 IU/L), the FIB-4 index significantly decreased in both groups.
• Adding SGLT2i improves liver enzymes but not the FIB-4 index for 96 weeks in patients taking pioglitazone.

Concluding further, treatment with SGLT2i improves the FIB-4 index compared to pioglitazone MAFLD patients over 96 weeks.

Further reading:

Mino, Masaaki, et al. "Effects of Sodium-Glucose Cotransporter 2 Inhibitors and Pioglitazone On FIB-4 Index in Metabolic Associated Fatty Liver Disease." Hepatology Research: the Official Journal of the Japan Society of Hepatology, 2023. https://www.unboundmedicine.com/medline/citation/36905232/full_citation