S2696 Glucagon-Like Peptide-1 Receptor Agonists Impact on Metabolic Dysfunction-Associated Liver Disease: A Retrospective Study

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major contributor to liver-related morbidity and mortality. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) offer a promising treatment; however, large-scale evidence of their impact on MASLD is limited. The objective of this study is to investigate the effect of GLP-1 RA on the progression of MASLD and its clinical outcomes. Methods: This is a retrospective cohort study that utilized the electronic health records database using the TriNetX platform. Our participants consisted of adults diagnosed with MASLD between 2014 and 2022. Patients were classified as GLP-1 RA users or non-users. After propensity score matching, a total of 105,980 patients (52,990 per group) were examined. The primary outcome was all-cause mortality, while secondary outcomes included all-cause hospitalizations, cardiovascular events, ischemic stroke, kidney injury, liver failure, cirrhosis, and liver transplantation. Results: At 3 years, GLP-1 RAs correlated with reduced all-cause mortality (aOR 0.381, 95% CI 0.358-0.406), hospitalizations (aOR 0.644, 95% CI 0.628-0.659), acute heart failure (aOR 0.568, 95% CI 0.544-0.593), acute myocardial infarction (aOR 0.769, 95% CI 0.727-0.815), ischemic stroke (aOR 0.867, 95% CI 0.816-0.920), acute kidney injury (aOR 0.650, 95% CI 0.627-0.675), and acute liver failure (aOR 0.451, 95% CI 0.388-0.524). Similarly, liver transplant rates were notably higher in the GLP-1 RA group (aOR 1.745, 95% CI 1.48-2.050), although there was no significant impact on cirrhosis or hepatocellular carcinoma rates. Conclusion: GLP-1 RAs are linked to considerable reductions in all-cause mortality, cardiovascular events, and metabolic complications in patients suffering from MASLD. These advantages emphasize their potential role as a critical therapeutic option for optimizing the management of MASLD.