{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T21:25:51Z","timestamp":1785792351896,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 CA255621"],"award-info":[{"award-number":["R01 CA255621"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 CA288375"],"award-info":[{"award-number":["U01 CA288375"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>GLP\u20101 receptor agonists (GLP\u20101RA) are widely used in type 2 diabetes mellitus (T2DM) and may confer hepatoprotective effects in metabolic dysfunction\u2010associated steatotic liver disease (MASLD). Their impact on liver fibrosis progression in real\u2010world clinical settings remains unclear. This study evaluated the link between GLP\u20101RA use and liver fibrosis progression in T2DM patients with early\u2010stage MASLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study emulating a target trial using electronic health records from the Mass General Brigham (MGB) system between 2010 and 2023. Adults with MASLD and T2DM who initiated GLP\u20101RA or dipeptidyl peptidase\u20104 inhibitor (DPP\u20104i) therapy and had baseline Fibrosis\u20104 (FIB\u20104) scores &lt;\u20092.67 were included. Propensity score matching (1:1) was applied to balance baseline covariates between groups. The primary outcome was progression to high\u2010risk FIB\u20104 (&gt;\u20092.67), confirmed by two consecutive values \u2265\u200990\u2009days apart within a one\u2010year period. The secondary outcome was a composite of cirrhosis, hepatic decompensation, hepatocellular carcinoma, or liver transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 2238 matched pairs were analysed. GLP\u20101RA use was associated with a lower risk of fibrosis progression compared to DPP\u20104i (incidence rate 3.25 vs. 4.29 per 100 person\u2010years; HR 0.75, 95% CI 0.65\u20130.87). Results were consistent in per\u2010protocol (HR 0.80) and landmark sensitivity analyses. The risk reduction was also observed across subgroups, including those with low baseline FIB\u20104, BMI &lt;\u200930, and users of statins, aspirin or metformin. No significant difference was found in secondary liver\u2010related outcomes (HR 0.98, 95% CI 0.72\u20131.34).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>GLP\u20101RA use significantly reduced the risk of liver fibrosis progression in patients with MASLD and T2DM, supporting its potential role in early disease modification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70447","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T09:44:22Z","timestamp":1763459062000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["<scp>GLP<\/scp>\n                    \u2010\n                    <scp>1RA<\/scp>\n                    and Liver Fibrosis Progression in\n                    <scp>MASLD<\/scp>\n                    and Type 2 Diabetes: Target Trial Emulation Using Propensity Score Matching"],"prefix":"10.1111","volume":"45","author":[{"given":"Jonggi","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Liver Center Asan Medical Center, University of Ulsan College of Medicine  Seoul Republic of Korea"},{"name":"Liver Center, Gastroenterology Division Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tushar","family":"Kamath","sequence":"additional","affiliation":[{"name":"Department of Medicine Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vy H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Przybyszewski","sequence":"additional","affiliation":[{"name":"Liver Center, Gastroenterology Division Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiunn","family":"Song","sequence":"additional","affiliation":[{"name":"Liver Center, Gastroenterology Division Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Medicine Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts 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