SGLT2 inhibitors preferred oral antidiabetic for individuals with both NAFLD and T2D,reveals study
Nonalcoholic fatty liver disease (NAFLD) is prevalent among individuals with type 2 diabetes (T2D) and presents a significant health burden. While various oral antidiabetic drugs (OADs) have been used in NAFLD management, there is a lack of clarity on which class offers the best outcomes. NAFLD commonly coexists with T2D, posing challenges for management. Understanding which OADs are most effective in NAFLD treatment is crucial for optimizing patient care and improving outcomes.
A recent retrospective cohort study sought to address this gap by comparing the efficacy of different OADs in NAFLD regression and liver-related outcomes. This study was published in the journal of JAMA Internal Medicine by Heejoon and colleagues. The study, conducted using population-level data from Korea, included patients with T2D and NAFLD. Patients receiving sodium-glucose cotransporter 2 (SGLT2) inhibitors, thiazolidinediones, dipeptidyl peptidase-4 (DPP-4) inhibitors, or sulfonylureas in combination with metformin were analyzed. NAFLD regression and liver-related outcomes were assessed over a follow-up period.
• The study involved 80,178 patients with type 2 diabetes and nonalcoholic fatty liver disease (NAFLD), with a mean age of 58.5 years, of which 53.6% were male.
• Sodium-glucose cotransporter 2 (SGLT2) inhibitors, thiazolidinediones, and dipeptidyl peptidase-4 (DPP-4) inhibitors were associated with a significant reduction in NAFLD severity compared to sulfonylureas.
• SGLT2 inhibitors exhibited the highest likelihood of NAFLD regression, followed by thiazolidinediones and DPP-4 inhibitors, when compared to sulfonylureas.
• Only SGLT2 inhibitors were significantly associated with lower rates of adverse liver-related outcomes, including hospitalization, mortality, liver transplant, and hepatocellular carcinoma, compared to sulfonylureas.
The study suggests that SGLT2 inhibitors may be preferred over other OADs in individuals with NAFLD and T2D due to their superior efficacy in promoting NAFLD regression and reducing adverse liver-related outcomes. These findings underscore the importance of reevaluating prescribing practices and warrant further research to validate these results.
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