ABSTRACT
Introduction
There is no conclusive evidence comparing the efficacy of glucagon-like peptide 1 (GLP-1) receptor agonists to the other guidelines recommended pharmacotherapy for nonalcoholic fatty liver disease (NAFLD). Therefore, we aim to compare the effects of GLP-1 receptor agonists, pioglitazone and vitamin E in patients with NAFLD.
Methods
We searched PubMed, Embase, Web of Science and Cochrane Library up to 11 April 2022. Randomized clinical trials (RCTs) comparing GLP-1 receptor agonists, pioglitazone and vitamin E against placebo or other active controls in patients with NAFLD were included.
Results
Nine RCTs including 1482 patients proved eligible. GLP-1 receptor agonists ranked first in steatosis, ballooning necrosis, γ-glutamyl transferase, body weight, body mass index, and triglycerides. Administration of GLP-1 receptor agonists, as compared with placebo, was associated with improvement in liver histology [steatosis (OR = 4.11, 95% CI: 2.83, 5.96), ballooning necrosis (OR = 3.07, 95% CI: 2.14, 4.41), lobular inflammation (OR = 1.86, 95% CI: 1.29, 2.68), fibrosis (OR = 1.52, 95% CI: 1.06, 2.20)].
Conclusions
GLP-1 receptor agonists were as effective as pioglitazone and vitamin E for liver histology among patients with NAFLD. GLP-1 receptor agonists might be considered as an alternative or complementary treatment in the future clinical practice.
Declaration of interests
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.
Reviewer Disclosures
Peer reviewers of this manuscript have no relevant financial or other relationships to disclose.
Author contributions
Y Gu, L Sun, and J Shi conceived the study. Y Gu and Y He designed the search strategy. L Yang, C Deng, T Kong, and R Zhou performed the literature search. C Deng, L Yang, Y Gu, T Kong, R Zhou, and Y Chen screened studies for eligibility. R Zhou and T Kong assessed the risk of bias. Y Gu, Y He, L Yang, C Deng, and Y Chen performed data extraction. Y Gu, L Sun, and W Zhang interpreted the data analysis. Y Gu, Y He, and L Sun wrote the first draft of the manuscript. All other authors revised the manuscript. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
Supplementary material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/17474124.2023.2172397