Glucagon-like peptide-1 receptor agonist (GLP-1-RAS) treatment in patients with cirrhosis: A scoping review
Abstract
Cirrhosis is a chronic disease characterized by diffuse fibrosis and morphological changes in the hepatic parenchyma. It is estimated that one-third of patients with cirrhosis also have diabetes. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown significant benefits in managing liver diseases, such as nonalcoholic fatty liver disease. However, little is known about its utility in patients with cirrhosis. This study aimed to explore the existing literature on the use of GLP-1 analogs in patients with hepatic cirrhosis, examining their potential advantages and disadvantages and possible indications for their use. Scoping reviews that included PubMed, Scopus, the International Clinical Trials Registry Platform search portal and ClinicalTrials were used. Six publications were included: prospective cohort (n=1), retrospective cohort (n=3), and clinical trial (n=2). The use of GLP-1 RAs proved beneficial in cirrhosis, demonstrating a decrease in mortality and complications and a reduction in weight. Using them over other available antidiabetic agents in this patient population is preferable. However, GLP-1 analogs in advanced fibrosis stages do not appear to be effective in reversing this condition.