title: Efficacy and safety of glucagon-like peptide-1 receptor agonists in non-alcoholic fatty liver disease: A systematic review and meta-analysis.
abstract: OBJECTIVE
  New drugs are urgently needed for the treatment of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). The aim of this meta-analysis was to evaluate the efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in NAFLD/NASH.
  
  
  METHODS
  We searched the MEDLINE, Embase, and Cochrane Library Central to identify randomized controlled trials (RCTs) and observational studies that compared GLP-1RAs with a control treatment or baseline values with respect to efficacy and safety in patients with NAFLD/NASH. Mean differences (MDs) with 95% confidence intervals (CIs) and odds ratios (ORs) were pooled using a random-effect model.
  
  
  RESULTS
  Six studies were eligible and included. Among the 329 NAFLD/NASH patients included in these studies, 277 patients had type 2 diabetes (T2D). GLP-1RA treatment produced significant reductions relative to baseline in liver histology scores for steatosis (MD, 0.80; 95% CI, 0.49 to 1.11), lobular inflammation (MD, 0.22; 95% CI, 0.00 to 0.45), hepatocellular ballooning (MD, 0.41; 95% CI, 0.15 to 0.67) and fibrosis (MD, 0.35; 95% CI, 0.00 to 0.70). Compared with placebo and positive agents, GLP-1RAs significantly reduced gamma-glutamyl transpeptidase (GGT) levels (MD, 13.8 U/L; 95% CI, 7.4 to 20.3; P<0.001). The reported major adverse events associated with GLP-1RA treatment included mild to moderate gastrointestinal discomfort that resolved within a few weeks.
  
  
  CONCLUSIONS
  Our study suggests that in NASH patients, particularly patients with diabetes, GLP-1RAs may improve liver histology and reduce aminotransferase levels from baseline. Benefits of GLP-1RAs are considered to outweigh the risks in NAFLD/NASH patients with or without diabetes.
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, China.
authors.forename: Yajie
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, China.
authors.forename: Qingguo
authors.initials: Q
authors.lastname: Lv
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, China.
authors.forename: Sheyu
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Chinese Evidence-Based Medicine Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Chinese Evidence-Based Medicine Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, China. Electronic address: buddyjun@hotmail.com.
authors.forename: Nanwei
authors.initials: N
authors.lastname: Tong
mesh_terms: D005234:Fatty Liver / Q000188:drug therapy; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage*; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000188:drug therapy*; D064887:Observational Studies as Topic; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016896:Treatment Outcome; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D000960:Hypolipidemic Agents; D000097789:Glucagon-Like Peptide-1 Receptor Agonists