1843-P: Clinical Efficacy Study of Orlistat Combined with Liraglutide in Patients with Metabolic Syndrome-Associated Steatohepatitis (MASLD)

Introduction and Objective: To evaluate the clinical efficacy of orlistat combined with liraglutide in obese patients with metabolic dysfunction-related fatty liver disease (MASLD). Methods: A total of 84 obese MASLD patients were randomly divided into orlistat group, liraglutide group, and combined therapy group (n=28 each), with 3 months of treatment. Outcomes included anthropometric indicators (e.g., weight), liver fibrosis markers, transaminase, lipid levels, and body composition Results: All three groups showed improvements in weight loss, basal metabolic rate reduction, fatty liver/fibrosis improvement, transaminase lowering, and fat reduction, with no significant lipid changes. The combined group had superior weight loss: -6.30 (-9.02, -4.37) kg (weight loss percentage:-6.38%), versus -3.65 (-7.22, -1.80) kg (weight loss percentage:-4.50%) (orlistat) and -4.30 (-7.40, -1.80) kg (weight loss percentage:-5.17%) (liraglutide). CAP and LSM improved in all groups, with the combined group achieving notable reductions. Additionally, the combined group had the highest total weight loss rate (8.16%) and fat reduction contribution rate (71.15%), and the lowest water loss rate (12.64%). Different weight loss magnitudes showed distinct body composition changes: ≤5% loss group had prominent fat-free mass reduction, 5%~10% group had the most significant fat reduction, and ≥10% group had stable fat/fat-free mass ratio. Conclusion: Compared with monotherapy, orlistat combined with liraglutide achieves better weight loss, liver function improvement, fat reduction, and muscle preservation in obese MASLD patients, presenting significant clinical efficacy. Disclosure C. Zhang: None. Y. Gu: None. Y. Pan: None.