GLP-1RA use in MAFLD, obesity lowers mortality, ‘provides cardiovascular benefits’
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Key takeaways:
- Patients taking GLP-1RAs had significantly lower risk for all-cause mortality.
- GLP-1RA use also was associated with reduced rates of major cardiovascular events, including acute myocardial infarction.
WASHINGTON — Patients with obesity and metabolic dysfunction-associated fatty liver disease taking glucagon-like peptide-1 receptor agonists had lower risk for all-cause mortality and major cardiovascular events, according to a presenter.
“As a future gastroenterologist and current physician advocating for patients with obesity, my research team and I found a critical need to explore the impact of these revolutionary medications in a patient population with only one drug that was just recently FDA-approved,” Luis Miguel Nieto, MD, from West Virginia University School of Medicine, told Healio. “The concerning growth of obesity and MAFLD in the U.S. prompted us to investigate the proven cardiovascular benefit that has been found in diabetic patients when using these medications.”
Using population-based data from TriNetX, Nieto and colleagues identified 137,008 patients with obesity and MAFLD who had not undergone bariatric surgery, of whom 24,398 received GLP-1RAs between January 2019 and May 2023. Researchers matched 20,981 patients taking GLP-1RAs (mean age, 52.1 years; 62.4% women) based on age, demographics, comorbidities and medication with 20,981 patients who were not taking GLP-1RAs (mean age, 52.2 years; 63% women).
The primary endpoint was all-cause mortality, and the secondary endpoint was a composite of cardiovascular events.
According to results presented at Digestive Disease Week, the GLP-1RA cohort had significantly lower all-cause mortality risk (HR = 0.4; 95% CI, 0.35-0.46) compared with the non-GLP-1RA cohort.
In addition, those taking GLP-1RAs had lower rates of cardiovascular events, including heart failure (HR = 0.76; 95% CI, 0.68-0.86), acute myocardial infarction (HR = 0.75; 95% CI, 0.63-0.9), unstable angina (HR = 0.76; 95% CI, 0.58-1) and cerebrovascular disease (HR = 0.91; 95% CI, 0.78-1.07), although no significant reductions were reported in coronary revascularization (HR = 0.49; 95% CI, 0.04-5.46) and hypertension (HR = 1.14; 95% CI, 1.02-1.27).
“The use of GLP-1RAs in patients with MAFLD and obesity provides cardiovascular benefits and early use can be considered,” Nieto told Healio.
“Access to this medication class is a real challenge for medical providers due to medication shortages and lack of coverage,” he added. “There is also a belief among physicians that diet and physical activity is enough to achieve weight loss for patients with obesity and MAFLD. With our findings, we strengthen the evidence of benefit from using GLP-1RAs in this patient population and can potentially improve use in patients that have access.”
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Nieto LM, et al. GLP-1 agonist use is associated with lower mortality and improvement of cardiovascular outcomes in patients with MAFLD and obesity: A multicenter analysis. Presented at: Digestive Disease Week; May 18-21, 2024; Washington (hybrid).
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