MASLD/MASH Pharmacologic Therapeutic Efficacy in a Predominately African American Medical Center Population

Introduction: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) can contribute to adverse liver-related outcomes and cardiac mediated events. Recognizing the benefits of weight loss in patients with MASLD, this study investigates the efficacy of glucagon-like peptide-1 (GLP-1) agonists in promoting weight reduction in a MASLD cohort. Methods: We identified 52 individuals with imaging confirmed liver steatosis. Weight loss (pounds) was calculated by comparing weights before and during GLP-1 therapy. Efficacy was evaluated by comparing GLP-1 users with non-users within a similar timeframe. Result: Of the 52 patients with a post-2020 follow-up, 33% were prescribed GLP-1 agonists. The majority were AA patients (33/52, 63%), with no racial disparities in GLP-1 agonist prescription rates. GLP-1 agonist users experienced significant and consistent weight loss (average of 16.8 lbs, p<0.004) compared to non-users, who had minimal weight change (0.4 lbs, p=0.92). Women were more likely to be prescribed GLP-1 agonists than men (41% vs. 15%, p=0.04), and patients with diabetes were also more likely to receive GLP-1 therapy than those without diabetes (41% vs. 18%). Statistically significant weight loss was observed in AA individuals, females, and patients with diabetes treated with GLP-1 agonists compared to their non-GLP-1 counterparts. Conclusions: GLP-1 agonist therapy was associated with an average weight loss of 16 pounds in MASLD patients, compared to less than 1 pound in non-users. These findings underscore the potential of GLP-1 agonist therapy in promoting weight reduction in both AA and non-AA MASLD patients, particularly when administered before the progression to advanced liver disease.