S2605 GLP-1 Analogs Linked to Lower Ascites, Paracentesis, and SBP Rates in Cirrhosis: Insights From a Retrospective Cohort Study

Introduction: Cirrhosis is a chronic liver condition marked by progressive dysfunction, leading to serious complications such as ascites, spontaneous bacterial peritonitis (SBP), and the need for paracentesis or transjugular intrahepatic portosystemic shunt (TIPS). Historically, management has focused on symptom control and preventing further liver damage. Glucagon-like peptide-1 (GLP-1) analogs, originally developed for type 2 diabetes, have recently drawn attention for potential liver-related benefits. Emerging data suggest GLP-1 agents may improve metabolic function and reduce inflammation, potentially lowering cirrhosis-related complications. Methods: We conducted a retrospective analysis using the TriNetX research network. Adults (≥18 years) with cirrhosis were included. Patients who initiated GLP-1 therapy after cirrhosis diagnosis were identified. Primary outcomes included the incidence of ascites, SBP, paracentesis, and TIPS. To minimize confounding, 1:1 propensity score matching was performed based on demographics, comorbidities (e.g., diabetes, obesity, CKD, hypertension), and lifestyle factors (e.g., alcohol, tobacco use). Cox proportional hazards regression analysis was used to assess associations, and hazard ratios (HRs) with 95% confidence intervals (CI) were reported. Results: The matched cohort analysis, which included 22,889 patients in both the GLP-1-treated and non-treated groups, revealed that GLP-1 analog use was significantly associated with a reduced risk of key cirrhosis- related complications. Patients treated with GLP-1 analogs exhibited a significantly lower risk of developing ascites (HR 0.499, 95% CI 0.480–0.520), requiring paracentesis (HR 0.379, 95% CI 0.352–0.407), and experiencing spontaneous bacterial peritonitis (HR 0.454, 95% CI 0.403–0.513). Additionally, there was a trend toward reduced risk of undergoing TIPS procedures (HR 0.653, 95% CI 0.338–1.262). Conclusion: The matched cohort analysis, which included 22,889 patients in both the GLP-1-treated and non-treated groups, revealed that GLP-1 analog use was significantly associated with a reduced risk of key cirrhosis- related complications. Patients treated with GLP-1 analogs exhibited a significantly lower risk of developing ascites (HR 0.499, 95% CI 0.480–0.520), requiring paracentesis (HR 0.379, 95% CI 0.352–0.407), and experiencing spontaneous bacterial peritonitis (HR 0.454, 95% CI 0.403–0.513). Additionally, there was a trend toward reduced risk of undergoing TIPS procedures (HR 0.653, 95% CI 0.338–1.262).