A large real-world study suggests that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may significantly improve survival and liver health in people with type 2 diabetes (T2DM) and metabolic dysfunction-associated liver disease (MASLD) or steatohepatitis (MASH). The findings were published in the AACE Endocrine Practice.

Using health data from over half a million adults with T2DM and MASLD/MASH, researchers compared outcomes in patients treated with GLP-1 RAs, pioglitazone (PGZ), or other antidiabetic medications.

After carefully matching patients in age, sex, and health status, the analysis revealed that GLP-1 RA therapy reduced all-cause mortality by 40.9% compared with controls. These medications were also linked to significantly lower rates of liver-related outcomes (LROs) (HR 0.77) and liver transplantation (HR 0.33).

PGZ use was associated with reduced LRO rates (HR 0.68) but did not improve overall survival. In patients with cirrhosis, GLP-1 RAs lowered transplant risk but did not significantly reduce mortality. Beyond liver benefits, GLP-1 RA therapy produced greater reductions in body mass index and HbA1c than other treatments.