In this retrospective study of 279 type 2 diabetes mellitus (T2DM) patients with metabolic dysfunction-associated steatotic liver disease (MASLD) in India, the clinical effectiveness of pioglitazone and sodium-glucose co-transporter 2 inhibitors (SGLT2i) was investigated. The primary endpoint, assessed at a one-year follow-up, focused on changes in fibrosis (FIB-4) index and the aspartate aminotransferase to platelet ratio index (APRI score). Of the 276 patients analyzed, 50% were on SGLT2i treatment, with 46% at low risk and 11% at high risk of advanced fibrosis. Of the total (276) patients, 46% of patients were at low risk of advanced fibrosis and 11% were at high risk for advanced fibrosis and majority (50%) were on SGLT2i treatment. At follow up there is a statistically significant reduction in the mean (SD) FIB-4 index (1.92 (1.22) vs. 1.68 (0.99)) and APRI score (0.42 (0.34) vs. 0.33 (0.21)); p <0.001. Among treatment-groups, there is a significant difference in the mean FIB-4 index both at baseline (F: 4.23; p <0.05) and follow up (F: 3.45; p <0.05); mean APRI score, the significance was observed only at baseline (F: 2.84; p <0.05). Importantly in all the treatment groups, there is a clinically significant improvement in FIB-4 index and APRI score. These findings suggest that the combination therapy may be beneficial in managing MASLD, particularly in reducing fibrosis indices in T2DM patients in the Indian population
D. Padhye: None. K. Seshadri: None.
