Glucagon-like peptide 1 (GLP1) agonists could be a treatment option to reduce risk of major adverse liver outcomes (MALO) in patients with type 2 diabetes mellitus (T2DM) and any chronic liver disease (CLD) who adhere to treatment over time, according to estimates using modelling of observational data to emulate a target trial of GLP1 agonists in this population.

Observational data from Swedish health-care registers 2010–2020 were used to emulate a target trial of GLP1 agonists in eligible patients with CLD (including metabolic dysfunction-associated steatotic liver disease) and T2DM. An inverse-probability weighted marginal structural model was used to compare parametric estimates of 10-year MALO risk (decompensated cirrhosis, hepatocellular carcinoma, liver transplantation or MALO-related death) in GLP1 agonist initiators (n = 1,026) versus non-initiators (n = 15,633). The risk of MALO was lower in the GLP1 agonist initiator group (who adhered to treatment) versus the non-initiator group in the 10-year per-protocol analysis (7.4% and 14.4%, respectively; RR = 0.51, 95% CI 0.14–0.88). However, the data were not compatible with a protective intention-to-treat effect, and the findings need to be corroborated in randomized clinical trials.

胰高血糖素样肽 1 (GLP1) 激动剂可能是一种治疗选择，可降低长期坚持治疗的 2 型糖尿病 (T2DM) 和任何慢性肝病 (CLD) 患者出现主要不良肝脏结局 (MALO) 的风险，根据估计，使用观察数据建模来模拟该人群中 GLP1 激动剂的目标试验。

使用 2010-2020 年瑞典医疗保健登记册的观察数据来模拟 GLP1 激动剂在符合条件的 CLD（包括代谢功能障碍相关的脂肪肝病）和 T2DM 患者中的目标试验。使用逆概率加权边际结构模型比较 GLP1 激动剂起始者 ( n  = 1,026) 与非起始者 ( n = 1,026) 10年 MALO 风险（失代偿性肝硬化、肝细胞癌、肝移植或 MALO 相关死亡）的参数估计。 =  15,633）。在 10 年按方案分析中，GLP1 激动剂起始药物组（坚持治疗）的 MALO 风险低于非起始药物组（分别为 7.4% 和 14.4%；RR = 0.51，95% CI 0.14） –0.88）。然而，这些数据与保护性意向治疗效果并不相符，研究结果需要在随机临床试验中得到证实。