Evidence mapPaperPMID 41974037Full record

ArticleHepatology communications2026

GLP-1RA plus SGLT2i combination therapy and liver fibrosis progression in MASLD with type 2 diabetes.

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

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Article in Hepatology communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Jonggi ChoiDivision of Gastroenterology, Liver Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0002-7470-5850
Gabby MitchellHarvard Medical School, Boston, Massachusetts, USA.
Vy H NguyenHarvard Medical School, Boston, Massachusetts, USA.
Eric PrzybyszewskiDivision of Gastroenterology, Liver Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Jiunn SongDivision of Gastroenterology, Liver Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Allison CarrollDepartment of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Megan MichtaDivision of Gastroenterology, Liver Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Erik AlmazanDepartment of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Tracey G SimonDivision of Gastroenterology, Liver Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Raymond T ChungDivision of Gastroenterology, Liver Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimThe combined use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) may provide synergistic benefits for liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM). We evaluated the comparative effectiveness of GLP-1RA plus SGLT2i versus GLP-1RA monotherapy on liver fibrosis progression.

methodsWe conducted a retrospective cohort study using data from the Mass General Brigham healthcare network (2010-2024). Adults with MASLD and T2DM initiating GLP-1RA therapy were included if their baseline FIB-4 scores indicated low-risk (<1.3) or intermediate-risk (1.3-2.67) categories. Combination therapy was defined as concurrent SGLT2i use for ≥50% of the GLP-1RA treatment period. The primary outcome was fibrosis progression, defined as advancement to a high-risk FIB-4 category. The secondary outcome was hepatic complications (cirrhosis, hepatocellular carcinoma, liver transplantation, or decompensation). Propensity score matching (1:2) was performed to minimize confounding.

resultsAfter matching, 879 combination therapy users were compared with 1690 monotherapy users. Combination therapy was associated with a significantly lower risk of fibrosis progression (3.10 vs. 4.01/100 person-years; HR 0.76, 95% CI 0.61-0.95) and a numerically lower incidence of hepatic complications (1.05 vs. 1.34/100 person-years; HR 0.76, 95% CI 0.53-1.09). Subgroup analyses showed consistent protective associations, with a significant benefit observed among patients with a BMI ≤35. Sensitivity analyses confirmed reduced fibrosis progression in both the ≥90-day and ≥180-day landmark analyses.

conclusionsGLP-1RA plus SGLT2i therapy was associated with reduced fibrosis progression compared with GLP-1RA monotherapy in MASLD and T2DM.

Indexed as

Diabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsLiver CirrhosisNon-alcoholic Fatty Liver DiseaseSodium-Glucose Transporter 2 InhibitorsAgedDisease ProgressionDrug Therapy, CombinationFemaleHumansMaleMiddle AgedRetrospective StudiesGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsGLP-1RAliver fibrosisMASLD

Identifiers

PMID41974037
PMCPMC13075898

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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.