Major Adverse Liver Outcomes With Tirzepatide and Injectable Semaglutide in Adults With Overweight or Obesity and Type 2 Diabetes

IF 4.9 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Pub Date : 2026-09-26 Epub Date: 2026-08-19 DOI:10.1002/oby.70277

Mainak Banerjee, Ajitesh Roy, Vivek Mohan Sharma, Abhishek Das

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引用次数: 0

Abstract

Objective

This study aimed to compare the effectiveness of tirzepatide versus injectable semaglutide in preventing major adverse liver outcomes (MALO) among adults with overweight or obesity and type 2 diabetes.

Methods

This retrospective target trial emulation utilized the TriNetX global network to analyze new users of tirzepatide and semaglutide. The primary outcome was time-to-first MALO (a composite of cirrhosis, decompensated events, and hepatocellular carcinoma). Propensity score matching balanced baseline covariates.

Results

Over a median follow-up of ~17 months, no significant difference in MALO risk was observed between tirzepatide and semaglutide initiators (estimated incidence rate [IR] 4.05 vs. 4.04 per 1000 person-years [PY]; hazard ratio [HR] 1.04, 95% CI 0.88–1.23). This comparable risk profile was maintained across sensitivity analyses, including people with MASLD (IR 9.97 vs. 10.03 per 1000 PY; HR 1.03, 95% CI: 0.75–1.42) and “as treated” analysis (HR 0.98, 95% CI: 0.80–1.21). Tirzepatide achieved greater BMI reduction (mean difference ~1.1 kg/m², p < 0.001). Internal validation confirmed both agents significantly outperformed sitagliptin.

Conclusions

In this high-risk population with type 2 diabetes, tirzepatide and injectable semaglutide offered comparable effectiveness in mitigating liver disease progression and MALO in the short- to medium-term follow-up.

查看原文本刊更多论文

替西帕肽和注射西马鲁肽治疗超重或肥胖和2型糖尿病的主要不良肝脏结局。

目的：本研究旨在比较替西帕肽与注射西马鲁肽在预防超重或肥胖和2型糖尿病成人主要不良肝脏结局（MALO）方面的有效性。方法：利用TriNetX全球网络进行回顾性目标试验模拟，分析替西帕肽和西马鲁肽的新使用者。主要终点是首次MALO时间（肝硬化、失代偿事件和肝细胞癌的组合）。倾向评分匹配平衡基线协变量。结果：在中位随访~17个月期间，替西帕肽和西马鲁肽启动剂在MALO风险方面无显著差异（估计发病率[IR] 4.05 vs. 4.04 / 1000人-年[PY]；风险比[HR] 1.04, 95% CI 0.88-1.23）。在敏感性分析中，包括MASLD患者（IR 9.97 vs. 10.03 / 1000 PY; HR 1.03, 95% CI: 0.75-1.42）和“治疗后”分析（HR 0.98, 95% CI: 0.80-1.21），这种可比较的风险状况保持不变。结论：在2型糖尿病高危人群中，在中短期随访中，替西帕肽和注射用西马鲁肽在缓解肝病进展和MALO方面的效果相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.