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.
Topic 2
Past research shows that people with type 2 diabetes have a higher risk for developing Alzheimer’s disease — a type of dementia impacting a person’s memory and behavior that currently has no cure.
Researchers believe this is because some of the underlying issues related to type 2 diabetes — such as obesity, heart disease, and high blood pressure — can predispose a person to Alzheimer’s disease.
Additionally, diabetes can potentially damage blood vessels
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in the brain, which can further raise a person’s dementia risk.
Now, researchers from Case Western Reserve University in Cleveland, OH, have found that semaglutide
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— the active ingredient in diabetes medications Ozempic, Rybelsus, and Wegovy, the latter of which is also prescribed for weight loss — may help lower Alzheimer’s disease risk in people with type 2 diabetes, when compared to seven other drugs used to treat diabetes.
The study was recently published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.
