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Non-alcoholic fatty liver disease has reached epidemic proportions in type 2 diabetes. Glucagon-like peptide-1 analogues are licensed in type 2 diabetes, yet little data exist on efficacy and safety in liver injury.
Dr Armstrong and colleagues from the United Kingdom assessed the safety and efficacy of 26-week liraglutide on liver parameters in comparison with active-placebo.
Individual patient data meta-analysis was performed using patient-level data combined from 6 different 26-week, phase-III, randomized controlled trials. The trials comprized the ‘Liraglutide Effect and Action in Diabetes’ (LEAD) program. The LEAD-2 sub-study was analyzed to assess the effect on CT-measured hepatic steatosis.  | | 51% of patients had an abnormal ALT at baseline | | Alimentary Pharmacology & Therapeutics |
Of 4442 patients analyzed, 51% of patients had an abnormal ALT at baseline. The team found that liraglutide 1.8 mg reduced ALT in these patients vs placebo, and was dose-dependent. The team noted that this effect was lost after adjusting for liraglutide's reduction in weight, and HbA1c. The research team observed that adverse effects with 1.8 mg liraglutide were similar between patients with and without baseline abnormal ALT. In LEAD-2 sub-study, liraglutide 1.8 mg showed a trend towards improving hepatic steatosis vs placebo. This difference was reduced when correcting for changes in weight, and HbA1c.
Dr Armstrong's team concludes, "We found that 26 weeks' liraglutide 1.8 mg is safe, well tolerated and improves liver enzymes in patients with type 2 diabetes. "This effect appears to be mediated by its action on weight loss and glycemic control."
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