Evidence map›Paper›PMID 42397506›Full record

Observational studyHepatology international2026

Efficacy of tirzepatide versus SGLT2 inhibitors in metabolic dysfunction-associated steatotic liver disease (MASLD): a multicenter propensity-matched real-world study.

Ibrahim Khalil, Pallab Sarker, Nabila Nur, Md Imran Hossain, Aizaz Anwar Khalid, Sajjad Ghanim Al-Badri, Mst Mahmuda Akter, Manisha Das, Mohd Turzo Rahman

Abstract readComparative StudyMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Hepatology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Ibrahim KhalilDhaka Medical College and Hospital, Dhaka, Bangladesh. ibrahim124904@gmail.com.ORCID http://orcid.org/0009-0002-8995-1058
Pallab SarkerDepartment of Internal Medicine, Reading Hospital, West Reading, PA, USA.
Nabila NurShaheed Suhrawardy Medical College, Dhaka, Bangladesh.
Md Imran HossainManikganj Medical College and Hospital, Manikganj, Bangladesh.
Aizaz Anwar KhalidPeshawar Medical College, Peshawar, Pakistan.ORCID http://orcid.org/0009-0002-4937-5500
Sajjad Ghanim Al-BadriCollege of Medicine, University of Warith Al-Anbiyaa, Karbala, Iraq.
Mst Mahmuda AkterManikganj Medical College and Hospital, Manikganj, Bangladesh.
Manisha DasDhaka Medical College and Hospital, Dhaka, Bangladesh.
Mohd Turzo RahmanDepartment of Internal Medicine, Flushing Hospital Medical Center, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent condition with significant cardiometabolic and hepatic risks. Tirzepatide, a dual GLP-1/GIP receptor agonist, shows promise in MASLD, but real-world comparative data against sodium-glucose cotransporter-2 inhibitors (SGLT2is) are lacking.

methodsIn this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity. Propensity Score Matching (1:1, caliper 0.1) balanced > 50 covariates. Primary outcomes included all-cause mortality, hospitalization, major adverse cardiovascular events (MACE), major adverse liver outcomes (MALO), and major adverse kidney events (MAKE) at 1- and 3-year follow-up, analyzed via Kaplan-Meier estimation and Cox proportional hazards models.

resultsTirzepatide was associated with significantly lower risks versus SGLT2is. At 1-year follow-up (n = 43,743 per group), all-cause mortality events were 144 (cumulative incidence 0.48%, KM event-free survival 99.52%) with tirzepatide versus 533 (1.38%, 98.62%) with SGLT2i (HR 0.328, 95% CI 0.272-0.394; log-rank p < 0.0001). All-cause hospitalization occurred in 3033 versus 7143 (HR 0.460, 95% CI 0.441-0.480). MACE events were 1064 versus 2376 (HR 0.506, 95%CI 0.471-0.544). MALO events were 149 versus 465 (HR 0.379, 95% CI 0.315-0.456). Hepatic failure and ascites also favored tirzepatide, while MAKE, varices, and hepatic encephalopathy showed no significant differences. Benefits persisted at 3 years (n = 39,838 per group): mortality 208 versus 963 (HR 0.374, 95% CI 0.321-0.436); hospitalization 3723 versus 9548 (HR 0.528, 95%CI 0.508-0.549); MACE 1260 versus 3282 (HR 0.545, 95%CI 0.510-0.582); and MALO 220 versus 726 (HR 0.478, 95%CI 0.410-0.558).

conclusionsIn this large real-world MASLD cohort, tirzepatide was associated with substantial reductions in mortality, hospitalizations, cardiovascular, and liver-related events compared to SGLT2is. These observational findings suggest potential advantages of tirzepatide and warrant prospective validation in randomized trials.

Indexed as

Diabetes Mellitus, Type 2Sodium-Glucose Transporter 2 InhibitorsTirzepatideAgedFemaleHumansMaleMiddle AgedPropensity ScoreRetrospective StudiesTreatment OutcomeSodium-Glucose Transporter 2 InhibitorsTirzepatideMASLDPropensity score matchingReal-world evidenceSGLT2 inhibitorsTirzepatide

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.