P3782 - Glucagon-Like Peptide-1 Receptor Agonists Impact on Metabolic Dysfunction-Associated Liver Disease: A Retrospective Study

Amani Elshaer, MBBS¹, Ramzi Ibrahim, MD¹, Hoang Nhat Pham, MD², Eiad Habib, MBBS¹, Tala B. Shahin, MD¹, Mahmoud Abdelnabi, MD¹, Fares Jamal, MD¹, Rama Mouhaffel, MD³, Hossam Elbenawi, MD⁴, Juan Maria Farina, MD¹, Bashar Aqel, MD¹, Michele Barnhill, MD¹, Chadi Ayoub, MD¹, Steven Lester, MD¹, Said Alsidawi, MD¹, Julie Rosenthal, MD¹, Eric Steidley, MD¹, Reza Arsanjani, MD¹
1Mayo Clinic, Phoenix, AZ; 2Banner - University of Arizona Tucson, Phoenix, AZ; 3Banner - University of Arizona Tucson, Tuscon, AZ; 4Mayo Clinic, Rochester, MN

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major contributor to liver-related morbidity and mortality. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) offer a promising treatment; however, large-scale evidence of their impact on MASLD is limited. The objective of this study is to investigate the effect of GLP-1 RA on the progression of MASLD and its clinical outcomes.

Methods: This is a retrospective cohort study that utilized the electronic health records database using the TriNetX platform. Our participants consisted of adults diagnosed with MASLD between 2014 and 2022. Patients were classified as GLP-1 RA users or non-users. After propensity score matching, a total of 105,980 patients (52,990 per group) were examined. The primary outcome was all-cause mortality, while secondary outcomes included all-cause hospitalizations, cardiovascular events, ischemic stroke, kidney injury, liver failure, cirrhosis, and liver transplantation.

Results: At three years, GLP-1 RAs correlated with reduced all-cause mortality (aOR 0.381, 95% CI 0.358-0.406), hospitalizations (aOR 0.644, 95% CI 0.628-0.659), acute heart failure (aOR 0.568, 95% CI 0.544-0.593), acute myocardial infarction (aOR 0.769, 95% CI 0.727-0.815), ischemic stroke (aOR 0.867, 95% CI 0.816-0.920), acute kidney injury (aOR 0.650, 95% CI 0.627-0.675), and acute liver failure (aOR 0.451, 95% CI 0.388-0.524). Similarly, liver transplant rates were notably higher in the GLP-1 RA group (aOR 1.745, 95% CI 1.48-2.050), although there was no significant impact on cirrhosis or hepatocellular carcinoma rates.

Discussion: GLP-1 RAs are linked to considerable reductions in all-cause mortality, cardiovascular events, and metabolic complications in patients suffering from MASLD. These advantages emphasize their potential role as a critical therapeutic option for optimizing the management of MASLD.

Figure: Figure 2. Flowchart for metabolic dysfunction-associated steatotic liver disease patients’ selection and cohort division.
A total of 1,395,788 patients with metabolic dysfunction-associated steatotic liver disease (MASLD) were identified and categorized into two groups: those treated with glucagon-like peptide-1 receptor agonists (GLP-1 Ras) and those who were not, forming a control group. After implementing propensity score matching (PSM), the final analysis included 105,980 patients, with 52,990 from each group.


Figure: Figure 2. Flowchart for metabolic dysfunction-associated steatotic liver disease patients’ selection and cohort division.
A total of 1,395,788 patients with metabolic dysfunction-associated steatotic liver disease (MASLD) were identified and categorized into two groups: those treated with glucagon-like peptide-1 receptor agonists (GLP-1 Ras) and those who were not, forming a control group. After implementing propensity score matching (PSM), the final analysis included 105,980 patients, with 52,990 from each group.

Disclosures:
Amani Elshaer indicated no relevant financial relationships.
Ramzi Ibrahim indicated no relevant financial relationships.
Hoang Nhat Pham indicated no relevant financial relationships.
Eiad Habib indicated no relevant financial relationships.
Tala Shahin indicated no relevant financial relationships.
Mahmoud Abdelnabi indicated no relevant financial relationships.
Fares Jamal indicated no relevant financial relationships.
Rama Mouhaffel indicated no relevant financial relationships.
Hossam Elbenawi indicated no relevant financial relationships.
Juan Maria Farina indicated no relevant financial relationships.
Bashar Aqel indicated no relevant financial relationships.
Michele Barnhill indicated no relevant financial relationships.
Chadi Ayoub indicated no relevant financial relationships.
Steven Lester indicated no relevant financial relationships.
Said Alsidawi indicated no relevant financial relationships.
Julie Rosenthal indicated no relevant financial relationships.
Eric Steidley indicated no relevant financial relationships.
Reza Arsanjani indicated no relevant financial relationships.

Amani Elshaer, MBBS¹, Ramzi Ibrahim, MD¹, Hoang Nhat Pham, MD², Eiad Habib, MBBS¹, Tala B. Shahin, MD¹, Mahmoud Abdelnabi, MD¹, Fares Jamal, MD¹, Rama Mouhaffel, MD³, Hossam Elbenawi, MD⁴, Juan Maria Farina, MD¹, Bashar Aqel, MD¹, Michele Barnhill, MD¹, Chadi Ayoub, MD¹, Steven Lester, MD¹, Said Alsidawi, MD¹, Julie Rosenthal, MD¹, Eric Steidley, MD¹, Reza Arsanjani, MD¹. P3782 - Glucagon-Like Peptide-1 Receptor Agonists Impact on Metabolic Dysfunction-Associated Liver Disease: A Retrospective Study, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.