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Diabetes Pill Shows Promise in Reducing Liver Scarring

A diabetes drug may soon double as a treatment for liver disease. Dapagliflozin, an SGLT-2 inhibitor typically used for type 2 diabetes, significantly improved liver inflammation and scarring in patients with metabolic dysfunction-associated steatohepatitis (MASH) during a clinical trial in China. Participants on the drug saw better liver outcomes and fewer side effects than those on a placebo. Although more research is needed, especially in diverse populations, this finding hints at a transformative role for existing medications in tackling liver diseases.
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The diabetes pill dapagliflozin has shown promising results in reducing liver scarring in a clinical trial published in The BMJ. The study found that treatment with dapagliflozin improved metabolic dysfunction-associated steatohepatitis (MASH), a condition where excess fat accumulates in the liver, leading to inflammation, and liver fibrosis, a build-up of scar tissue.

The trial involved 154 adults diagnosed with MASH after a liver biopsy at six medical centers in China. Almost half had type 2 diabetes, and almost all had liver fibrosis. The participants were randomly assigned to receive either 10 mg of dapagliflozin or a matching placebo once daily for 48 weeks.

The results showed that treatment with dapagliflozin improved MASH in 53% of participants without worsening of fibrosis, compared to 30% in the placebo group. Resolution of MASH without worsening of fibrosis occurred in 23% of participants in the dapagliflozin group, compared to 8% in the placebo group.

Fibrosis improvement without worsening of MASH was also reported in 45% of participants in the dapagliflozin group, compared to 20% in the placebo group. The percentage of participants who discontinued treatment due to adverse events was 1% in the dapagliflozin group and 3% in the placebo group.

The researchers acknowledged that the trial was conducted in a Chinese population, which limits its broader generalizability, and that female and older patients were under-represented. However, they pointed out that results were consistent after further analyses, suggesting they are robust.

The study’s findings indicate that dapagliflozin may affect key aspects of MASH by improving both steatohepatitis and fibrosis. Large-scale and long-term trials are needed to further confirm these effects.

In the coming years, researchers expect exciting developments in the field of pharmacological treatment for MASH, with more drugs becoming available and therapeutic decisions becoming increasingly tailored to individual patient profiles. Ideally, such treatments should provide cardiovascular benefit, have an established safety profile, and be accessible to broad and diverse patient populations.

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