Glucagon like peptide-1 (GLP-1) therapy is associated with reduced risk of developing cirrhosis and liver cancer in people with type 2 diabetes with chronic liver disease

GLP-1 therapy is widely used to treat type 2 diabetes and induce weight loss. Previous studies have also shown benefits of GLP-1 in reducing cardiovascular disease in obese/overweight people with¹ or without diabetes.² Early clinical studies also suggest benefits of GLP-1 therapy to reduce liver damage.³ To further explore the effectiveness of GLP-1 therapy to improve liver disease in people type 2 diabetes and chronic liver disease, researchers at the Karolinska Institutet undertook a register based study.

The study published in the journal Gut,⁴ used observational data from Swedish healthcare registers 2010–2020 to identify patients with chronic liver disease and type 2 diabetes. 10-year MALO risk (decompensated cirrhosis, hepatocellular carcinoma, liver transplantation or MALO-related death) was analyzed for initiators of GLP1 agonists versus non-initiators. The investigators found that among those who adhered to taking GLP-1 therapy, the risk of developing liver disease was halved (7.4%) compared with those not taking GLP-1 therapy (14.4%). The reduction in the risks of developing liver disease with GLP-1 therapy persists at 6 years with corresponding relative risk of 5.4% compared with 9.0% respectively. The study also showed that those who continued to take the drug for a long period of time had a lower risk of developing more severe forms of liver disease such as cirrhosis and liver cancer.

This study is based on retrospective data, and is therefore limited by various confounders. Nonetheless, evidence based on this work provided a basis for a larger study in a clinical trial setting to assess the efficacy of GLP-1 therapy to prevent liver disease progression in people with type 2 diabetes with chronic liver disease. This is important since there is currently no drug that is licenced for this indication. The research was mainly funded by Region Stockholm (CIMED), the Swedish Research Council and the Swedish Cancer Society.