Efficacy and safety of GLP-1 receptor agonists in MASH with fibrosis: A systematic review and meta-analysis

Metabolic dysfunction-associated steatohepatitis (MASH) with fibrosis is a major driver of liver-related morbidity and mortality, yet effective pharmacologic options remain limited. This meta-analysis shows that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) significantly increase histologic resolution of MASH without worsening fibrosis and improve fibrosis stage without worsening MASH. Simultaneously, they improve metabolic risk factors, supporting their role as disease-modifying agents in patients with at-risk MASH. These benefits, together with a favorable safety profile, highlight their potential as a dual-target therapeutic strategy for hepatologists and endocrinologists managing this high-risk population. Future trials assessing long-term clinical outcomes will be essential to guide guideline development, inform access policies, and support the extension of GLP-1 RA use.

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Publication Details

Journal
JHEP Reports
Published
2025-12-11
DOI
https://doi.org/10.1016/j.jhepr.2025.101708
Primary Topic
Liver Disease Diagnosis and Treatment
Type
article
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article

Efficacy and safety of GLP-1 receptor agonists in MASH with fibrosis: A systematic review and meta-analysis

Ana Flávia Conegundes, Manal F. Abdelmalek, Giovanni Gosch Berton, Jefferson Manoel Borges Martins et al.
JHEP Reports
Liver Disease Diagnosis and Treatment
article

Efficacy and safety of GLP-1 receptor agonists in MASH with fibrosis: A systematic review and meta-analysis

Ana Flávia Conegundes, Manal F. Abdelmalek, Giovanni Gosch Berton, Jefferson Manoel Borges Martins, Eliabe Silva de Abreu, Aladdin Dahbour, Marcelo Albuquerque Barbosa Martins, Matheus Vanzin Fernandes, Rafael dos Santos Borges, Luiza Haikal de Paula
article en

Abstract

Metabolic dysfunction-associated steatohepatitis (MASH) with fibrosis is a major driver of liver-related morbidity and mortality, yet effective pharmacologic options remain limited. This meta-analysis shows that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) significantly increase histologic resolution of MASH without worsening fibrosis and improve fibrosis stage without worsening MASH. Simultaneously, they improve metabolic risk factors, supporting their role as disease-modifying agents in patients with at-risk MASH. These benefits, together with a favorable safety profile, highlight their potential as a dual-target therapeutic strategy for hepatologists and endocrinologists managing this high-risk population. Future trials assessing long-term clinical outcomes will be essential to guide guideline development, inform access policies, and support the extension of GLP-1 RA use.

JHEP ReportsVol. 8(4)
Universidade Federal de Ouro Preto (BR), Universidade Federal de Minas Gerais (BR), Mayo Clinic (US), Universidade Federal de Ciências da Saúde de Porto Alegre (BR), Universidade de Passo Fundo (BR), Mayo Clinic in Arizona (US), Indiana University – Purdue University Indianapolis (US), Universidade Federal do Pará (BR)
Openalex Percentile: Top 49%
Liver Disease Diagnosis and Treatment
DOIOpen Access PDFOpenAlex
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