Why the study?
GLP-1 analogs have shown potential benefits in reducing liver inflammation and complications, but their effects on mortality and clinical outcomes in patients with cirrhosis required further insight.
Does GLP-1 analog therapy reduce all-cause mortality and liver-related complications in adults with cirrhosis?
Does GLP-1 analog therapy reduce all-cause mortality and liver-related complications in adults with cirrhosis?
In patients with cirrhosis, GLP-1 analog use is associated with significantly lower all-cause mortality and reduced risks of hepatic encephalopathy, hepatorenal syndrome, and portal hypertensive bleeding.
GLP-1 use was associated with lower mortality and complications in cirrhosis; leaves open whether RCTs will confirm benefits.
BACKGROUND: Cirrhosis is characterized by complications, including hepatic encephalopathy (HE), hepatorenal syndrome (HRS), and acute variceal bleeding, Glucagon-like peptide-1 (GLP-1) analogs, have shown potential benefits in reducing liver inflammation and lowering cirrhosis-related complications. This study aims to provide insights into the effect of GLP-1 therapy on mortality and clinical outcomes in patients with cirrhosis. METHODS: We conducted a retrospective analysis using TriNetX research network. The cohort comprised patients ≥18 years old with a diagnosis of cirrhosis. Patients who were started on GLP-1 analogs after the diagnosis of cirrhosis were identified. Primary outcomes included all-cause mortality, HE, HRS, and portal hypertensive bleeding. Variables such as age, sex, race, comorbidities (e.g., diabetes, obesity, chronic kidney disease, hypertension), and lifestyle factors underwent 1:1 propensity matching to reduce confounding. Cox proportional hazards regression analysis was utilized to analyze the matched cohorts, and hazard ratios (HR) with 95% confidence intervals. RESULTS: GLP-1 analog use was significantly associated with a reduced risk of several cirrhosis-related complications. Patients treated with GLP-1 analogs exhibited a significantly lower risk of all-cause mortality (HR 0.374, 95%CI 0.359-0.392), HE (HR 0.900, 95%CI 0.843-0.959), and HRS (HR 0.554, 95%CI 0.496-0.619). Additionally, there was reduced rates of portal hypertensive bleeding among GLP-1 users (HR 0.487, 95%CI 0.444-0.533). CONCLUSION: This study demonstrates that GLP-1 analog use is associated with a significantly lower risk of all-cause mortality and cirrhosis-related complications. Furthermore, the reduced rate of portal hypertensive bleeding might correlate with subsequent decrease in hospitalizations.
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ONWUZO et al. (2026) studied this question.
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