Evidence mapPaperPMID 40336058Full record

Trial reportBMC medicine2025

Synergistic benefit of thiazolidinedione and sodium-glucose cotransporter 2 inhibitor for metabolic dysfunction-associated steatotic liver disease in type 2 diabetes: a 24-week, open-label, randomized controlled trial.

Minyoung Lee, Sukchul Hong, Yongin Cho, Hyungjin Rhee, Min Heui Yu, Jaehyun Bae, Yong-Ho Lee, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT03646292. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03646292 phase4completed

Comparison of The Effects of Thiazolidinediones(TZD), Sodium- Glucose Cotransporter 2 Inhibitors(SGLT2i) Alone and TZD / SGLT2i Combination Therapy on Metabolic Dysfunction-Associated Steatotic Liver Disease in Patients With Type 2 Diabetes

Ran2018Enrolled51Registered outcomes9Posted comparisons0ConditionsDigestive System Disease, Empagliflozin, Fatty Liver, Hypoglycemic AgentsArmsCombination of pioglitazone and empagliflozin, empagliflozin, Pioglitazone
Open the trial in the graph
3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Review
  2. Review
  3. Current management of MASLD in type 2 diabetes.Hormones (Athens, Greece) · 2026
    Review
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  5. Review
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  7. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Minyoung LeeDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
Sukchul HongDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
Yongin ChoDepartment of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
Hyungjin RheeDepartment of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Min Heui YuSENTINEL Team, Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Jaehyun BaeDivision of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Yong-Ho LeeDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
Byung-Wan LeeDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
Eun Seok KangDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
Bong-Soo ChaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea. bscha@yuhs.ac.ORCID http://orcid.org/0000-0003-0542-2854

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe close interplay between metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes supports the need to identify beneficial combination therapies of antidiabetic medications targeted for the treatment of MASLD. This study aimed to investigate the complementary effects of combination therapy with pioglitazone (PIO) and empagliflozin (EMPA) on MASLD in individuals with type 2 diabetes.

methodsIn a randomized, open-label trial, 50 participants with type 2 diabetes and MASLD were assigned 1:1:1 to receive PIO 15 mg, EMPA 10 mg, or a combination (PIO 15 mg plus EMPA 10 mg) daily for 24 weeks. Liver fat fraction and stiffness were evaluated using magnetic resonance imaging-proton density fat fraction (MRI-PDFF) and magnetic resonance elastography (MRE), respectively.

resultsCombination therapy resulted in the largest reduction in liver fat and stiffness among treatment groups. Participants experiencing a relative reduction ≥ 30% or an absolute reduction ≥ 5% in liver fat were the most prevalent in the combination group (100.0% vs. 57.1% in PIO and 87.5% in EMPA, p = 0.010). In addition, the combination group showed the highest proportion of individuals with a relative reduction ≥ 30% in liver fat and ≥ 20% in liver stiffness than the monotherapy groups (50.0% vs. 21.4% in PIO and 6.3% in EMPA, p = 0.029). Combination therapy did not induce the changes in subcutaneous fat deposition observed in the monotherapy groups, but it did show the most substantial reduction in visceral fat, concurrently showing the largest increase in adiponectin level across the three groups (p = 0.036).

conclusionsCombination therapy of PIO with EMPA showed synergistic benefits for MASLD in individuals with type 2 diabetes, compensating for the inadequate or unfavorable effects of monotherapies; ClincialTrials.gov number, NCT03646292.

trial registrationThe trial was registered at ClinicalTrials.gov (registration number: NCT03646292).

Indexed as

Benzhydryl CompoundsDiabetes Mellitus, Type 2Fatty LiverGlucosidesHypoglycemic AgentsPioglitazoneSodium-Glucose Transporter 2 InhibitorsThiazolidinedionesAgedDrug SynergismDrug Therapy, CombinationFemaleHumansLiverMaleMiddle AgedBenzhydryl CompoundsempagliflozinGlucosidesHypoglycemic AgentsPioglitazoneSodium-Glucose Transporter 2 InhibitorsThiazolidinedionesMetabolic dysfunction-associated steatotic liver diseaseSodium-glucose cotransporter 2 inhibitorThiazolidinedioneType 2 diabetes

Identifiers

PMID40336058
PMCPMC12060414

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.