OBJECTVES: Non-alcoholic fatty liver disease (NAFLD) is the predominant cause of chronic liver disease worldwide. NAFLD prevalence increases with the rising incidence of type 2 diabetes mellitus (T2DM). Currently, lifestyle interventions and weight loss are used as the major therapeutic strategy in most of the patients with NAFLD. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are being used in the treatment of T2DM and the data regarding its effectiveness and safety in NAFLD patients is still not extensive[1]

METHODS: Clinical trials which included GLP1 Agonists as an intervention for patients with NAFLD, were identified in databases such as, Cochrane, and MEDLINE (via PubMed). No language and publication year restrictions were applied. Two researchers independently reviewed studies using the Cochrane methodology for systematic reviews. Outcomes of interest included Hepatic Fat Fraction, Liver stiffness, Non-alcoholic fatty liver disease Fibrosis Score (NFS) and safety.

RESULTS: In total, 195 potentially relevant studies were screened. 9 clinical trials with 592 Asian patients having NAFLD were included. Out of 9, 7 randomized controlled studies are with Liraglutide as a primary treatment in comparison with Placebo, Insulin, Diet as control, The Hepatic Fat Fraction significantly decreased (~38%) in the GLP group in comparison with control (~20 %) group at 24 weeks. In addition to HFF, NFS improved significantly in GLP group than other control group. GLP Agonists mainly affects the GI system, hence few of the patients shown Nausea or vomiting.

CONCLUSIONS: GLP1 agonists are prominent treatment options for NAFLD patients with good clinical activity and minimal side-effects. The clinical trials clearly revealed its efficacy on Hepatic fat fraction. However, the results need to be interpreted cautiously due to limited number of trials available.

References: Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64:73–84