The effects of liraglutide on liver enzymes and metabolic factors in patients with nonalcoholic steatohepatitis: a meta-analysis of randomized controlled trials

Adnan Malik; Waseem Amjad; Faisal Inayat; Mahum Nadeem; Simcha Weissman; Muhammad Imran Malik; Ans Ahmad Jajja; Ahmad Khan; James H Tabibian

doi:10.5114/pg.2022.112775

The effects of liraglutide on liver enzymes and metabolic factors in patients with nonalcoholic steatohepatitis: a meta-analysis of randomized controlled trials

Prz Gastroenterol. 2023;18(1):100-109. doi: 10.5114/pg.2022.112775. Epub 2022 Jan 23.

Authors

Adnan Malik¹, Waseem Amjad², Faisal Inayat³, Mahum Nadeem⁴, Simcha Weissman⁵, Muhammad Imran Malik⁶, Ans Ahmad Jajja³, Ahmad Khan⁷, James H Tabibian⁸

Affiliations

¹ Loyola University Medical Center, Maywood, IL, USA.
² Harvard Medical School, Boston, MA, USA.
³ Allama Iqbal Medical College, Lahore, Pakistan.
⁴ Oklahoma University Medical Center, Oklahoma City, OK, USA.
⁵ Hackensack University Palisades Medical Center, North Bergen, NJ, USA.
⁶ Airedale General Hospital, Keighley, West Yorkshire, UK.
⁷ Case Western Reserve University, Cleveland, OH, USA.
⁸ Olive View-UCLA Medical Center, Sylmar, CA, USA.

Abstract

Introduction: Nonalcoholic steatohepatitis (NASH) is the most common cause of chronic liver disease, but no drug therapies have been approved to date. While glucagon-like peptide-1 (GLP-1) analogues may help in the management, the existing evidence remains conflicting.

Aim: This meta-analysis aims to elucidate the efficacy of liraglutide in patients with NASH.

Material and methods: We searched 4 databases for randomized controlled trials assessing the efficacy of liraglutide in patients with NASH. We analysed continuous outcomes using the mean difference (MD) and relative 95% confidence interval (CI), while dichotomous outcomes were analysed using the risk ratio (RR) and relative 95% CI. Primary endpoints included alanine aminotransferase (ALT) (IU/l), aspartate aminotransferase (AST) (IU/l), alkaline phosphatase (ALP) (IU/l), and γ-glutamyl transferase (GGT) (IU/l). Secondary outcomes were body mass index (BMI) (kg/m²), waist circumference (cm), total cholesterol (TC) (mmol/l), triglyceride (TG) (mmoll), high-density lipoprotein (HDL) (mmol/l), low-density lipoprotein (LDL) (mmol/l), and glycated hemoglobin (HbA_1c) (%).

Results: A total of 5 clinical trials were included. The analysis showed that liraglutide is effective in increasing HDL (MD = +0.10 (-0.18, -0.02), p = 0.02) and reducing LDL levels in blood (MD = -0.29 (-0.56, -0.02), p = 0.04). No significant difference was noted in levels of ALT (MD = 2.66 (-1.56, 6.87), p = 0.22), AST (MD = -1.99 (-5.70, 1.72), p = 0.29), GGT (MD = 5.02 (-0.86, 10.90), p = 0.09), ALP (MD = -5.16 (-11.90, 1.59), p = 0.13), TC (MD = -0.31 (-0.65, 0.03), p = 0.07), or TG (MD = -0.14 (-0.53, 0.25), p = 0.48). The HbA_1c (%) level was found to be significantly reduced in the liraglutide arm (MD = -0.62 (-0.88, -0.36), p < 0.01).

Conclusions: Liraglutide effectively improves the lipid profile in patients with NASH.

Keywords: liraglutide; liver enzymes; metabolic factors; nonalcoholic steatohepatitis.