Oral Semaglutide May Boost Liver Health in Type 2 Diabetes

TOPLINE:
A 48-week oral semaglutide treatment regimen for type 2 diabetes (T2D) reduces weight and improves liver steatosis, liver stiffness, and liver enzyme levels in patients with metabolic dysfunction–associated steatotic liver disease (MASLD), with a similar safety profile to that of subcutaneous semaglutide.
METHODOLOGY:
Obesity and T2D increase the likelihood of MASLD, which can cause liver inflammation and fibrosis, leading to cirrhosis and cancer. Injectable glucagon-like peptide 1 receptor agonists have shown beneficial effects on liver histology in patients with MASLD, but the efficacy and safety of oral formulations need to be validated.
Researchers conducted a prospective study to evaluate the clinical benefits and safety of a 48-week oral semaglutide treatment regimen.
Overall, 80 patients with MASLD and T2D were enrolled and initiated on oral semaglutide, of which 70 (40 women; median age, 56 years; median body mass index, 29.5) completed the 48-week treatment regimen.
Patients were assessed at baseline and every 12 weeks for clinical and laboratory data, including body mass index, liver enzymes, lipid profile, and glycemic control.
Liver steatosis and fibrosis were evaluated using transient elastography and liver fibrosis markers.
TAKEAWAY:
Body weight, liver enzymes, lipid profile, and glycemic control (P < .01 for all) improved with oral semaglutide treatment for 48 weeks.
Controlled attenuation parameter (CAP) values decreased from baseline (318 dB/m) to 48 weeks (300 dB/m; P < .01), indicating reduced liver steatosis.
Changes in CAP values significantly correlated with changes in body weight (r, 0.44; P < .01), while changes in alanine aminotransferase levels correlated with changes in body weight (r, 0.37; P < .01) and A1c levels (r, 0.44; P < .001), indicating benefits may be mediated through weight loss.
Most adverse events were gastrointestinal symptoms of mild to moderate severity and were transient; 3 of the 80 original patients discontinued treatment early because of adverse events.
IN PRACTICE:
“Oral semaglutide treatment improves not only diabetic status, lipid profile, and body weight but also liver steatosis and injury and noninvasive fibrosis markers,” the authors wrote.
SOURCE:
This study was led by Taeang Arai, MD, Division of Gastroenterology and Hepatology, Nippon Medical School, Tokyo, Japan. It was published online in Diabetes, Obesity and Metabolism.
LIMITATIONS: 
Histologic evaluation via liver biopsy was not performed to diagnose MASLD. Because oral semaglutide has been approved only for patients with T2D in Japan, this study cohort only included patients with MASLD and T2D, limiting the generalizability of the findings to those without T2D. Furthermore, the single-arm design of this study suggests that caution is needed when interpreting the results.
DISCLOSURES:
This study did not declare any source of funding. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
 
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