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Efficacy and Safety of GLP-1 Receptor Agonists in Patients with MASLD: A Systematic Review and Meta-analysis of Randomized Clinical Trials
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  • Basile Njei,
  • Yazan A. Al-Ajlouni,
  • Samira Yaya Lemos,
  • Derek Ugwendum,
  • Prince Ameyaw,
  • Lea-Pearl Njei,
  • Sarpong Boateng
Basile Njei
Yale University School of Medicine Section of Digestive Diseases

Corresponding Author:[email protected]

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Yazan A. Al-Ajlouni
New York Medical College School of Medicine
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Samira Yaya Lemos
Hopital Central de Yaounde
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Derek Ugwendum
Richmond University Medical Center
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Prince Ameyaw
Yale Affiliated Hospitals Program
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Lea-Pearl Njei
University of Maryland
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Sarpong Boateng
Yale Affiliated Hospitals Program
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Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) significantly impacts global health, with a prevalence affecting roughly 25% of adults worldwide. GLP-1 receptor agonists (GLP-1RAs) offer potential therapeutic benefits beyond glycemic control, including improvement in hepatic steatosis, inflammation, and fibrosis. Objectives: This study aims to systematically review and meta-analyze randomized clinical trials to evaluate the efficacy and safety of GLP-1RAs in MASLD patients, focusing on hepatic outcomes, cardiovascular outcomes, anthropometric measurements, and mortality. Methods: Following PRISMA guidelines, a comprehensive database search was conducted to include RCTs assessing GLP-1RAs’ effects on MASLD. Quality assessment was conducted using the Revised Cochrane Risk of Bias tool. Our meta-analysis utilized a random-effects model, calculating standardized mean differences for continuous outcomes to determine the agents’ efficacy and safety. Additionally, funnel plots were generated to assess publication bias, ensuring the integrity of our meta-analytical findings. Results: The review included 27 trials, revealing GLP-1RAs significantly improved hepatic function markers (ALT, AST, GGT, and liver fat content) and cardiovascular risk factors (fasting blood sugar, HbA1c levels, lipid profiles). Additionally, GLP-1RAs were associated with significant reductions in body weight, BMI, subcutaneous fat, and waist circumference. Conclusion: GLP-1RAs demonstrate a promising therapeutic role in managing MASLD, offering benefits that extend to improving liver function, mitigating cardiovascular risk, and promoting weight loss. Further research is needed to confirm these findings and optimize GLP-1RAs’ usage in MASLD treatment.