Evidence mapPaperPMID 41215582Full record

ArticleClinical and molecular hepatology2026

Comparative risk of fibrosis progression with sodium-glucose cotransporter-2 vs. dipeptidyl peptidase-4 inhibitors in metabolic dysfunction-associated steatotic liver disease and type 2 diabetes mellitus with low-to-intermediate fibrosis.

Jonggi Choi, Daniel Fulop, Vy H Nguyen, Eric Przybyszewski, Jiunn Song, Allison Carroll, Megan Michta, Erik Almazan, Tracey G Simon, Raymond T Chung

Abstract readComparative Study
In one paragraph

Article in Clinical and molecular hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Jonggi ChoiDepartment of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Daniel FulopDepartment of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Vy H NguyenHarvard Medical School, Boston, MA, USA.
Eric PrzybyszewskiLiver Center, Gastroenterology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jiunn SongLiver Center, Gastroenterology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Allison CarrollDepartment of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Megan MichtaLiver Center, Gastroenterology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Erik AlmazanDepartment of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Tracey G SimonLiver Center, Gastroenterology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Raymond T ChungLiver Center, Gastroenterology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Funding

Trial of Statins for Chemoprevention in Hepatocellular CarcinomaR01CA255621 · MASSACHUSETTS GENERAL HOSPITAL · 2025 to 2025
$1.5M
Therapeutic modulation of a proteomic HCC risk signature with statins in patients with liver cirrhosisU01CA288375 · UT SOUTHWESTERN MEDICAL CENTER · 2025 to 2025
$628k
Gilead SciencesNCI NIH HHS R01 CA255621NCI NIH HHS U01 CA288375NIH HHS R01 CA255621NIH HHS U01 CA288375
6 · The paper itself

Abstract

BACKGROUND/

aimsMetabolic dysfunction-associated steatotic liver disease (MASLD) is a growing cause of cirrhosis and its complications. Given its close association with type 2 diabetes mellitus (T2DM), evaluating whether sodium-glucose cotransporter-2 inhibitors (SGLT2is) can mitigate the progression of liver fibrosis is clinically important. We examined the association between SGLT2i use and liver fibrosis progression in patients diagnosed with MASLD and T2DM.

methodsWe conducted a target trial emulation study using a retrospective, active comparator new-user design among adults with MASLD, T2DM, and low-to-intermediate Fibrosis-4 (FIB-4≤2.67) scores who initiated treatment with either SGLT2is or dipeptidyl peptidase-4 inhibitors (DPP-4is) at Mass General Brigham or Asan Medical Center from 2013 to 2023. The primary outcome was the progression to advanced fibrosis (FIB-4>2.67), confirmed on ≥2 occasions within 1 year. The secondary outcome was the development of major adverse liver outcomes (MALO), including incident cirrhosis, decompensation events, hepatocellular carcinoma, or liver transplantation.

resultsAmong 16,901 eligible patients, 2,571 propensity score-matched pairs were identified with balanced baseline characteristics. During follow-up (median, 3.7 years), fibrosis progression occurred at a rate of 3.46/100 personyears in SGLT2i users and 4.44 in DPP4i users. SGLT2i use was associated with a lower risk of fibrosis progression (HR 0.78, 95% CI 0.67-0.89; P<0.001). No significant difference in MALO incidence was observed. Subgroup analyses showed a consistent association among users of metformin, statins, and aspirin.

conclusionsSGLT2i use was associated with reduced risk of fibrotic progression compared to DPP4i use in adults with MASLD and T2DM.

Indexed as

Diabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsFatty LiverLiver CirrhosisSodium-Glucose Transporter 2 InhibitorsAdultAgedDisease ProgressionFemaleHumansMaleMiddle AgedRetrospective StudiesDipeptidyl-Peptidase IV InhibitorsSodium-Glucose Transporter 2 InhibitorsFatty liverFibrosisLiver fibrosisMASLD

Identifiers

PMID41215582
PMCPMC12835736

What Socratic holds

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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.