{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T20:54:56Z","timestamp":1790456096218,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Both pioglitazone and glucagon\u2010like peptide 1 receptor agonists (GLP1RA) alone improve metabolic dysfunction\u2010associated steatohepatitis (MASH) in randomized clinical trials, whereas preclinical studies suggested MASH benefits with sodium glucose co\u2010transporter 2 inhibitors (SGLT2i). In the real world, patients with type 2 diabetes often require multiple agents for glycaemic control. Here, we investigated the benefits of combining these agents on risks of MASH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Longitudinal changes in FibroScan\u2010aspartate aminotransferase (FAST) score were measured in 888 patients with type 2 diabetes. Use of pioglitazone, GLP1RA and\/or SGLT2i was defined as continuous prescriptions of \u2265180\u2009days prior to their last reassessment FibroScan. Multivariable logistic regression analysis was conducted to evaluate the associations between use of these agents and FAST score changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over a median follow\u2010up of 3.9\u2009years, the increasing number of these agents used was significantly associated with more reductions in FAST score (\n                      <jats:italic>p<\/jats:italic>\n                      for trend &lt;0.01). Dual combination was independently associated with a higher likelihood of achieving low FAST score at reassessment than single use of any of these agents (odds ratio [OR] 2.84,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Among the different drug combinations, using SGLT2i and pioglitazone (median dose 15\u2009mg daily) together, as compared to not using any of these three agents, was associated with a higher likelihood of both low FAST score at reassessment (OR 6.51,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) and FAST score regression (OR 12.52,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), after adjusting for changes in glycaemic control and body weight during the study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combining SGLT2i and pioglitazone is a potentially useful strategy to ameliorate \u2018at\u2010risk\u2019 MASH in patients with type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.16049","type":"journal-article","created":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T03:29:47Z","timestamp":1730777387000},"page":"574-582","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Benefits of combining\n                    <scp>SGLT2<\/scp>\n                    inhibitors and pioglitazone on risk of\n                    <scp>MASH<\/scp>\n                    in type 2 diabetes\u2014A real\u2010world study"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7569-409X","authenticated-orcid":false,"given":"Chi\u2010Ho","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine University of Hong Kong, Queen Mary Hospital  Hong Kong China"},{"name":"State Key Laboratory of Pharmaceutical Biotechnology, Li Ka Shing Faculty of Medicine University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9813-1126","authenticated-orcid":false,"given":"David Tak\u2010Wai","family":"Lui","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2266-3935","authenticated-orcid":false,"given":"Lung\u2010Yi","family":"Mak","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine University of Hong Kong, Queen Mary Hospital  Hong Kong China"},{"name":"State Key Laboratory of Liver Research, Li Ka Shing Faculty of Medicine University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol Ho\u2010Yi","family":"Fong","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylie Sze\u2010Wing","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy Ho\u2010Cheung","family":"Mak","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7884-5295","authenticated-orcid":false,"given":"Chloe Yu\u2010Yan","family":"Cheung","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing\u2010Sun","family":"Chow","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Cho","family":"Woo","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, 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