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Ipragliflozin, pioglitazone show similar improvements in fatty liver
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Adults with type 2 diabetes and nonalcoholic fatty liver disease treated with the SGLT2 inhibitor ipragliflozin or the thiazolidinedione pioglitazone experienced improvements in the liver-to-spleen ratio, as well as serum aminotransferase levels and glycemic parameters, according to recent study findings from Japan.
Daisuke Ito, MD, PhD, of the department of endocrinology and diabetes at Saitama Medical University in Japan, and colleagues evaluated adults with type 2 diabetes and nonalcoholic fatty liver disease (NAFLD) randomly assigned to oral ipragliflozin 50 mg (n = 32) or pioglitazone (Actos, Takeda) 15 to 30 mg (n = 34) once daily to determine the safety and efficacy of each. Change from baseline in the liver-to-spleen attenuation ratio on CT at week 24 served as the primary outcome.
At 24 weeks, the liver-to-spleen ratio significantly increased by 0.22 in the ipragliflozin group and by 0.21 in the pioglitazone group; there were no significant differences between the two groups.
Aspartate aminotransferase and alanine aminotransferase levels significantly decreased from baseline in both groups. Similar decreases also appeared between the two groups for HbA1c and fasting plasma glucose. Body weight decreased by 2.3 kg in the ipragliflozin group and increased by 0.9 kg in the pioglitazone group at 24 weeks compared with baseline.
Serious adverse events did not occur in either group.
“Ipragliflozin was shown to exert beneficial effects on NAFLD that were identical to those of pioglitazone during the 24-weel trial period,” the researchers wrote. “We observed an amelioration of hepatic steatosis as evaluated using the [liver-to-spleen] ratio, reduced serum aminotransferase levels, and lowering of other NAFLD parameters, with equivalent beneficial effects observed for glycemic parameters. Compared with pioglitazone, there were significant decreases in body weight and abdominal fat area. Tolerability was also favorable.” – by Amber Cox
Disclosures: Ito reports receiving lecture fees from Astellas, AstraZeneca, Ono and Merck Sharp & Dohme. Please see the full study for a list of all other authors’ relevant financial disclosures.
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