Empagliflozin for non-diabetic metabolic dysfunction-associated steatotic liver disease: a promising therapeutic agent in transition
Abstract
the most studied are vitamin E and pioglitazone. While vitamin E has shown histological benefits in non-diabetic patients, concerns about long-term safety (e.g., prostate cancer risk) limit its routine use (7). Pioglitazone, a peroxisome proliferator-activated receptor gamma (PPAR-γ ) agonist, improves insulin sensitivity and hepatic steatosis but is associated with weight gain, fluid retention, and potential cardiovascular risk (7). Glucagon-like peptide-1 receptor agonists (GLP-1RAs), such as liraglutide and semaglutide, have shown promising effects on liver fat reduction and even MASH resolution in trials but are injectable and also costly (8). Lubiprostone, which modulates intestinal permeability and the gut-liver axis, has recently shown promise by significantly reducing liver fat in MASLD patients over 48 weeks. Its safety profile and oral administration enhance its potential, though further studies are required to confirm
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