Evaluating the effects of dapagliflozin on fatty liver and liver scarring in Type 2 diabetes

This study evaluated the effects of dapagliflozin (Farxiga) on the build-up of fat and scar tissue in the liver of patients with Type 2 diabetes (T2D) and fatty liver disease. This study concluded that dapagliflozin may reduce fat buildup and scarring in the liver in these patients.

About 40 – 50% of patients with T2D also have non-alcoholic fatty liver disease. This disease is characterized by a build-up of fat in the liver. 20 – 30% of patients with fatty liver disease also have liver scarring, which can severely damage the liver.

Sodium-glucose co-transporter 2 inhibitors (SGLT2 inhibitors) help the kidneys remove glucose from the body through the urine. SGLT-2 inhibitors have been shown to improve blood sugar and body weight in patients with T2D. Dapagliflozin is an SGLT-2 inhibitor. Whether dapagliflozin can improve fat and scar tissue build-up in the liver of patients with T2D and fatty liver disease remains under investigation.

This study involved 63 patients with T2D and fatty liver disease. Patients received either dapagliflozin (55.6%) or standard anti-diabetic medication (44.4%; control group) for 24 weeks. 90.5% of all patients completed the study.

The amount of fat buildup and scar tissue in the liver were measured using ultrasound. Liver stiffness was used as an indicator of the amount of scar tissue in the liver. Higher liver stiffness was associated with more scarring.

In the dapagliflozin group, HbA1c levels (an average of blood sugar levels of the last 3 months) decreased significantly from 8.37% to 7.36%. HbA1c also decreased in the control group, but it was not significant (from 7.7% to 7.22%).

Fat buildup in the liver was significantly lower in the dapagliflozin group compared to the control group (290.3 vs. 311.3 units) after 24 weeks. The percent reduction of fat in the liver from baseline to 24 weeks was significantly larger in the dapagliflozin group (102.2%) compared to the control group (92.4%). There was also a significant improvement in liver function in the dapagliflozin group compared to the control group.

In patients with significant liver scarring (8.0 units or more), dapagliflozin treatment significantly decreased liver stiffness from 14.7 to 11.0 units after 24 weeks. The percent reduction of liver stiffness from baseline to 24 weeks was significantly larger in the dapagliflozin group compared to the control group (95.3% vs. 77.9%).

This study concluded that dapagliflozin improved fat buildup and scarring in the liver in patients with Type 2 diabetes and fatty liver disease. The authors suggest that dapagliflozin may prevent the development of liver cirrhosis (irreversible liver scarring that kills liver cells) in these patients.

This study only included Japanese patients, so these results may not be applicable to all patients.

Also, the patient population in this study was quite small. The control group in this study was not a placebo (substance with no active effect) group. Larger studies with longer study periods are needed to confirm these results.