Dulaglutide Effectively Treats Early NAFLD With Diabetes, Fi
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Dulaglutide when included in standard type 2 diabetes (T2D) treatment helps in significant reduction of liver fat in patients with type 2 diabetes and NAFLD, according to a recent study in the journal Diabetologia. This means that the GLP agonist Dulaglutide can be considered for the early treatment of NAFLD in T2D patients.

Liraglutide, a daily injectable glucagon-like peptide-1 receptor (GLP-1r) agonist, has been shown to reduce liver fat content (LFC) in humans. Data regarding the effect of dulaglutide, a once-weekly GLP-1r agonist, on human LFC are scarce. This study examined the effect of dulaglutide on LFC in individuals with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD).

Effect of dulaglutide on liver fat (D-LIFT) was a 24 week, open-label, parallel-group, randomised controlled trial to determine the effect of dulaglutide on liver fat at a tertiary care centre in India. 64 adults who had type 2 diabetes and MRI-derived proton density fat fraction-assessed LFC of greater than 6.0% at baseline, were randomly assigned to receive dulaglutide weekly for 24 weeks or usual care, based on a predefined computer-generated number with a 1:1 allocation that was concealed using serially numbered, opaque, sealed envelopes.

The primary endpoint was the difference of the change in LFC from 0 to 24 weeks between groups. The secondary outcome measures included the difference of the change in pancreatic fat content (PFC), change in liver stiffness measurement (LSM in kPa) measured by vibration-controlled transient elastography, and change in liver enzymes.

Results:
-- Eighty-eight patients were screened; 32 were randomly assigned to the dulaglutide group and 32 to the control group.

-- Overall, 52 participants were included for per-protocol analysis: those who had MRI-PDFF data at baseline and week 24. Dulaglutide treatment resulted in a control-corrected absolute change in LFC of -3.5% and relative change of -26.4%, corresponding to a 2.6-fold greater reduction.

-- Dulaglutide-treated participants also showed a significant reduction in Gamma-glutamyl transpeptidase (GGT) levels and non-significant reductions in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels.

-- Absolute changes in PFC and LSM were not significant when comparing the two groups.

-- There were no serious drug-related adverse events.

Conclusively, when included in the standard treatment for type 2 diabetes, dulaglutide significantly reduces LFC and improves GGT levels in participants with NAFLD. There were non-significant reductions in PFC, liver stiffness, serum AST and serum ALT levels. Dulaglutide could be considered for the early treatment of NAFLD in patients with type 2 diabetes.

Source: https://link.springer.com/article/10.1007/s00125-020-05265-7
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