Effect of ipragliflozin on liver enzymes in type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

ABSTRACT

Introduction

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is estimated to affect upto 70–80% of people with type 2 diabetes mellitus (T2DM). Although several anti-hyperglycemic drugs have been shown to be effective in such patients, there remains an unmet need for newer drugs. The objective of this meta-analysis was to analyze the effect of ipragliflozin on aspartate aminotransferase (AST), alanine transaminase (ALT), and gamma-glutamyl transpeptidase (GGT) levels in patients with T2DM.

Methods

A literature search on electronic databases was conducted to identify potential randomized clinical trials (RCT) as per predetermined study selection criteria. Mean difference (MD) was calculated using Cochrane review manager.

Results

Twelve studies were included in the meta-analysis, including 1349 subjects. Compared to the control group, ipragliflozin as a monotherapy showed a significant reduction in levels of ALT at week 12 (p = 0.02) and at week 24 (p = 0.007), GGT at week 12 (p < 0.00001). Ipragliflozin as an add-on therapy showed significant reduction in levels of AST at week 24 (p < 0.00001), ALT at week 12 (p = 0.002), ALT at week 24 (p < 0.00001), and GGT at week 24 (p < 0.00001).

Conclusion

Findings suggest the beneficial effects of ipragliflozin on liver enzymes. Further large-scale RCTs are required to confirm ipragliflozin’s role for liver-related conditions in T2DM.

KEYWORDS:

• SGLT2 inhibitors
• ipragliflozin
• AST
• ALT
• GGT
• type 2 diabetes mellitus

Article highlights

• The meta-analysis of 12 studies on T2DM patients receiving ipragliflozin demonstrated significant reductions in ALT, AST, and GGT levels compared to control groups.

• These findings underscore the potential of ipragliflozin as a promising therapeutic option for type 2 diabetes mellitus with elevated liver enzymes.

• Additional robust and high-quality long-term safety studies are required to further substantiate and validate these findings.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Authors’ contributions

R Parveen, S Hussain, and N Agarwal designed the study. R Parveen and S Saini screened the literature independently. S Hussain, P Khan, and S Saini abstracted the data and cross-checked the data in pairs. N Agarwal and N Saha resolved discrepancies in literature screening and data abstraction. R Parveen, N Agarwal, P Khan, and N Saha drafted the work or revised it critically for important intellectual content and have given final approval of the version published. All authors contributed to manuscript revision. All authors have read and agreed to the published version of the manuscript.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14656566.2024.2360078

Additional information

Funding

This paper was not funded.