Table 3 Major clinical trials assessing incretins in patients with MASLD

GLP-1R agonists

dulaglutide

64 adults with T2DM and more than 6.0% LFC by MRI-PDFF

Reduce absolute LFC by 3.5% and liver enzyme after 24 weeks

[97]

Exenatide

76 overweight/obese patients with T2DM and LFC by MRS ≥ 10.0%

Reduce LFC by 17.55U/L and fibrosis 4 score by 0.10 after 24-week treatment

[98]

Liraglutide

52 overweight patients with NASH proved by biopsy

Achieve resolution in 39% participants and reduce progression of fibrosis (9% vs 36% in the control group) after 48 weeks

[99]

Semaglutide

320 patients with NASH and liver fibrosis (F1-F3) proved by biopsy

Achieve NASH resolution without worsening fibrosis in 36–59% participants after 72-week intervention. Improve liver fibrosis in 43% participants in the 0.4-mg group

[100]

GLP-1R/GIP co-agonist

Tirzepatide

296 overweight/obese participants with T2DM and fatty liver index of at least 60

Reduce absolute MRI-PDFF LFC by 8.09% after 52-week intervention

[108]

316 patients with type 2 diabetes with or without stable metformin therapy

Reduce ALT, AST, keratin-18 and procollagen III after 26 weeks

[109]