Nowak Klaudia, Łupina Krzysztof, Romac Anna, Kalisz Aleksandra, Ilkiewicz Łucja, Janczura Jakub
Collegium Medicum, Jan Kochanowski University, Kielce, Poland.
Ann Pharmacother. 2025 Mar 12:10600280251322002. doi: 10.1177/10600280251322002.
OBJECTIVE: To summarize the current knowledge on the therapeutic potential of GLP-1 receptor agonists in managing metabolic associated steatotic liver disease (MASLD). DATA SOURCES: A literature review was conducted using the search terms , , , , , and on PubMed (from January 1, 2019, through February 1, 2025), National Institutes of Health (NIH) (from January 1, 2019, through February 1, 2025), Scopus (from January 1, 2019, through February 1, 2025), and the World Health Organization (WHO) data. STUDY SELECTION AND DATA EXTRACTION: All relevant clinical trials, review articles, package inserts, and guidelines evaluating clinically relevant evidence regarding the therapeutic potential of GLP-1 agonists in MASLD were considered for inclusion. DATA SYNTHESIS: GLP-1 RAs have shown promising results in MASLD treatment. Semaglutide has demonstrated efficacy in reducing liver fat content, inflammation, and fibrosis, with clinical trials indicating improvements in hepatic biomarkers and cardiometabolic risk factors. Similarly, tirzepatide has been associated with substantial weight loss and significant reductions in liver fat and fibrosis markers. Both agents exert their effects through mechanisms involving improved insulin sensitivity, reduced lipid accumulation, and attenuation of hepatic inflammation. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: Given the high prevalence of MASLD in patients with obesity and type 2 diabetes, tirzepatide and semaglutide could play a critical role in clinical practice by addressing multiple facets of the disease. Both agents have shown potential in reducing liver fat, improving hepatic biomarkers, and mitigating cardiometabolic risks, which are leading causes of morbidity and mortality in MASLD patients. Incorporating these therapies into MASLD treatment guidelines could significantly enhance patient outcomes by targeting both liver-related and systemic complications of the disease. CONCLUSIONS: GLP1 RAs show great potential in managing MASLD by promoting weight loss, improving glycemic control, and reducing liver inflammation.
目的：总结目前关于胰高血糖素样肽-1（GLP-1）受体激动剂在治疗代谢相关脂肪性肝病（MASLD）方面的治疗潜力的知识。 数据来源：使用搜索词 、 、 、 、 、 和 在PubMed（从2019年1月1日至2025年2月1日）、美国国立卫生研究院（NIH）（从2019年1月1日至2025年2月1日）、Scopus（从2019年1月1日至2025年2月1日）以及世界卫生组织（WHO）数据上进行文献综述。 研究选择与数据提取：所有评估GLP-1激动剂在MASLD治疗潜力的临床相关证据的相关临床试验、综述文章、药品说明书和指南均被考虑纳入。 数据综合：GLP-1受体激动剂在MASLD治疗中已显示出有前景的结果。司美格鲁肽已证明在降低肝脏脂肪含量、炎症和纤维化方面有效，临床试验表明肝脏生物标志物和心血管代谢危险因素有所改善。同样，替尔泊肽与显著的体重减轻以及肝脏脂肪和纤维化标志物的显著降低有关。这两种药物都通过改善胰岛素敏感性、减少脂质积累和减轻肝脏炎症等机制发挥作用。 与患者护理和临床实践的相关性：鉴于MASLD在肥胖和2型糖尿病患者中患病率很高，替尔泊肽和司美格鲁肽通过解决该疾病的多个方面，可能在临床实践中发挥关键作用。这两种药物在减少肝脏脂肪、改善肝脏生物标志物和降低心血管代谢风险方面均显示出潜力，而这些是MASLD患者发病和死亡的主要原因。将这些疗法纳入MASLD治疗指南可以通过针对该疾病的肝脏相关和全身并发症，显著提高患者的治疗效果。 结论：GLP-1受体激动剂通过促进体重减轻、改善血糖控制和减少肝脏炎症，在管理MASLD方面显示出巨大潜力。
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