S1562 Efficacy and Safety of Semaglutide in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Introduction: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease, with an estimated worldwide prevalence of 32.4%. Unfortunately, to date, there are no approved pharmacotherapies for NAFLD or non-alcoholic steatohepatitis (NASH). The aim of this study was to assess the efficacy and safety of semaglutide in patients with NAFLD. Methods: MEDLINE, CENTRAL, and Embase were searched from inception to May 1, 2023, to identify eligible randomized controlled trials (RCTs). Meta-analysis was performed using random effects model expressing continuous outcomes as mean differences (MD) or standardized mean differences (SMD), and dichotomous outcomes as odds ratios (OR) with 95% confidence intervals (CI). Statistical heterogeneity was assessed using the Cochran’s Q test and I2 statistic. Results: Three RCTs involving 458 patients with NAFLD were included. Semaglutide improved histological outcomes compared to placebo, with significantly higher likelihood of NASH resolution (OR 3.18, 95% CI 1.70 to 5.95, I2=0%), improvement in steatosis (OR 2.83, 95% CI 1.19 to 6.71, I2=57%), lobular inflammation (OR 1.81, 95% CI 1.11 to 2.96, I2=0%), and hepatocellular ballooning (OR 2.92, 95% CI 1.83 to 4.65, I2=0%), but not fibrosis stage (OR 0.71, 95% CI 0.15 to 3.41, I2=80%). Radiologically, semaglutide significantly reduced liver stiffness (SMD -0.48, 95% CI -0.86 to -0.11, I2=57%) and steatosis (MD -4.96%, 95% CI -9.92 to 0.01, I2=64%). It also significantly reduced ALT (MD -14.06 U/L, 95% CI -22.06 to -6.07, I2=0%) and AST (MD -11.44 U/L, 95% CI -17.23 to -5.65, I2=0%). Patients treated with semaglutide had improved cardiometabolic outcomes, including greater decreases in HgA1c (MD -0.77%, 95% CI -1.18 to -0.37, I 2=75%) and weight loss (MD -6.53 kg, 95% CI -11.21 to -1.85, I2=0%) compared to the placebo. However, semaglutide was associated with higher occurrence of GI-related side effects (OR 3.72, 95% CI 1.68 to 8.23, I2=49%), but the overall risk of serious adverse events was comparable between the 2 groups (OR 1.40, 95% CI 0.75 to 2.62, I2=0%). Conclusion: Semaglutide demonstrated significant improvements in NASH resolution and NAFLD Activity Score components, but not in fibrosis stage. Furthermore, semaglutide resulted in radiologic improvements in liver stiffness and steatosis, liver enzymes, and cardiometabolic outcomes while maintaining a well-tolerated safety profile. Further trials of longer duration are needed to investigate its efficacy in fibrosis regression.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.023 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.029 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".