Abstract
Armstrong M, Gaunt P, Aithal G, et al.
Lancet 2016; 387: 679–690.
Non-alcoholic steatohepatitis (NASH) is the commonest cause of chronic liver disease globally and results in both liver- and cardiovascular-related morbidity and mortality. There are currently no drug therapies licensed for NASH. The long-acting glucagon-like peptide-1 (GLP-1) analogue, liraglutide, is licensed for the treatment of type 2 diabetes and is known to improve steatosis in mouse models and isolated human hepatocytes. Thus far, however, data on the effects of GLP-1 analogues in human liver have been limited to case reports and retrospective studies of liver enzymes in patients with type 2 diabetes.
Yu et al. have performed a randomized, double-blind, placebo-controlled trial of liraglutide in UK patients with histologically confirmed NASH. Fifty-two patients received either 1.8 mg daily of liraglutide or placebo for 48 weeks. In summary, treatment with liraglutide led to a significant improvement in histological steatosis and hepatocyte ballooning, with reduced progression of fibrosis, compared with placebo.
Given the well-established metabolic improvements seen with liraglutide treatment, these results are not a surprise but are important nevertheless as the first trial to report beneficial effects of GLP-1R agonism in NASH.