Comparative efficacy of multiple drugs for non-alcoholic fatty liver disease: a Bayesian network meta-analysis
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD), now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD), is the most prevalent chronic liver disease worldwide. However, it remains unclear which drug treatment is more effective. Therefore, we conducted a network meta-analysis to comprehensively compare the efficacy of several potentially beneficial hypoglycemic drugs and vitamin E in treating patients with NAFLD.
Methods: This Bayesian network meta-analysis searched PubMed, Embase, Web of Science, and the Cochrane Library for randomized controlled trials (RCTs). We employed random-effects models to calculate mean differences (MD), relative risk (RR), and 95% confidence intervals (CI). The study outcomes included anthropometric measurements, biological markers, hepatic fat content, and liver biopsy results. The protocol for this systematic review with network meta-analysis was registered on PROSPERO (CRD42024532600).
Results: This analysis included 26 RCTs with 2143 patients. Based on the surface under the cumulative ranking curve and the network meta-analysis matrix, glucagon-like peptide-1 receptor agonists (GLP-1RA) demonstrated superior efficacy compared to other interventions, particularly in terms of weight loss, improvement in liver enzymes, resolution of non-alcoholic steatohepatitis (NASH), reduction of hepatic fat content, glycemic control, and improvement in insulin resistance. Additionally, compared to placebo, sodium-glucose…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,143 participants or records.
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