4.3 Review

The role of glucagon-like peptide-1 receptor agonists in nonalcoholic fatty liver disease

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TAYLOR & FRANCIS LTD
DOI: 10.1080/17512433.2023.2274536

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Exenatide; glucagon-like peptide-1 receptor agonists; hepatic steatosis; liraglutide; nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; semaglutide; treatment

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There is evidence that GLP-R1As treatment has beneficial effects on NAFLD, such as improving liver function and histological improvement in hepatic steatosis and inflammation. However, further research is needed to evaluate the early use of GLP-R1As in NAFLD patients without fibrosis and in combination with other medications for advanced disease, which may have additive or synergistic effects on NAFLD.
IntroductionNonalcoholic fatty liver disease (NAFLD) is a highly prevalent disease, associated with obesity, type 2 diabetes mellitus and dyslipidemia, which can lead to liver cirrhosis and hepatocellular carcinoma in some patients. Apart from lifestyle modifications, which are the cornerstone for its management, several drugs are under evaluation, including glucagon-like peptide-1 receptor agonists (GLP-R1RAs). In this review, we summarized major clinical data concerning the effects of GLP-1RAs on NAFLD, trying to highlight existing knowledge and to elucidate areas of uncertainty, thus providing clues to potential clinical implications and research.Areas coveredSelected clinical studies on GLP-R1As in NAFLD are presented in this narrative review.Expert opinionThere is evidence that treatment with GLP-R1As in NAFLD has beneficial effects on NAFLD, i.e. improvement in liver function tests and histological improvement in hepatic steatosis and inflammation, but not fibrosis. Further research is required toward the early use of GLP-R1 Alpha s, i.e. in NAFLD patients without fibrosis to evaluate whether they may prevent the progression to fibrosis, or in patients with advanced disease in combination with other medications, which may have additive or even synergistic effects on NAFLD.

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