In this systematic review and meta-analysis, We searched PubMed, Medline, Web of Science and The Cochrane Library databases. All randomized controlled trials involving GLP-1RAs and NAFLD or NASH were collected since the database was established. A meta-analysis of proportions was done with the generalised linear mixed model. Continuous variables were represented by Mean and Standard Deviation (SD), and binary variable were represented by Relative Risk (RR) and 95% Confidence Interval (CI) as effect indicators. The research results were presented by Revman 5.4. This study is registered with PROSPERO (CRD42023390735).
We included 16 placebo-controlled or active drug-controlled randomized controlled trials (involving 2178 patients) that used liraglutide, exenatide, dulaglutide, or semaglutie in the treatment of NAFLD or NASH, as measured by liver biopsy or imaging techniques. This study found that the effect of GLP-1RAs on histologic resolution of NASH with no worsening of liver fibrosis (n=2 RCTs; WMD:4.08, 95%CI 2.54-6.56, p < 0.00001) has statistically significant. At the same time, GLP-1RAs affected CRP (n = 7 RCTs; WMD:-0.41, 95% CI-0.78 to -0.04, p =0.002) and other serological indicators were significantly improved.
This study evaluated the efficacy of GLP-1RAs in patients with NAFLD and NASH. These results suggest that GLP-1RAs may be a potential and viable therapeutic approach as a targeted agent to intervene in disease progression of NAFLD and NASH.
方法:在本系统综述和荟萃分析中,我们搜索了PubMed,Medline,WebofScience和Cochrane图书馆数据库。自数据库建立以来,收集了所有涉及GLP-1RAs和NAFLD或NASH的随机对照试验。使用广义线性混合模型对比例进行了荟萃分析。连续变量用平均值和标准偏差(SD)表示,和二元变量由相对风险(RR)和95%置信区间(CI)表示为效果指标。研究结果由Revman5.4提供。本研究在PROSPERO(CRD42023390735)注册。
结果:我们纳入了16项安慰剂对照或活性药物对照的随机对照试验(涉及2178名患者),艾塞那肽,杜拉鲁肽,或semaglutie治疗NAFLD或NASH,通过肝活检或成像技术测量。这项研究发现,GLP-1RAs对NASH的组织学分辨率的影响没有肝纤维化恶化(n=2个RCTs;WMD:4.08,95CI2.54-6.56,p<0.00001)具有统计学意义。同时,GLP-1RAs影响CRP(n=7个RCTs;WMD:-0.41,95%CI-0.78至-0.04,p=0.002)等血清学指标明显改善。
结论:本研究评估了GLP-1RAs对NAFLD和NASH患者的疗效。这些结果表明,GLP-1RAs可能是一种潜在和可行的治疗方法,作为靶向药物干预NAFLD和NASH的疾病进展。