Description

Welcome back to What’s it Worth! Join your hosts, Dr. Diana Langworthy and Dr. Peyton Braun (PGY1 Pharmacy Resident), as we sift through strengths and limitations of at trial assessing the effects of empagliflozin on nonalcoholic fatty liver disease.  The authors sought to quantify the impact of Sodium Glucose Cotransporter 2 - inhibitors (SGLT2i's) on Metabolic Dysfunction Associated Liver Disease (MASLD).  This episode is full of EBP detective moments - dissecting trial language to get a clear picture of the story. Let's dive in and see what its worth!  

Key Points

1. MASLD is a condition marked by an accumulation of fat in the liver which can lead to inflammation and irreversible liver damage
2. MASLD is often associated with conditions such as obesity, diabetes and hypertension 
3. SGLT2i's are an evidence based therapy for the treatment of type II diabetes and have also shown to improve outcomes in heart failure and kidney disease
4. Extraglycemic benefits of this class of agents are of particular interest, with an increasing number of clinical trials investigating their potential impact on a variety of diseases (including MASLD)
5. Does a trial conducted with non-probability sampling have enough internal validity for empagliflozin in MASLD? ------> Tune in to find out!

References

1. [EPISODE TRIAL] Shojaei, F., Erfanifar, A., Kalbasi, S. et al. The effect of empagliflozin on non-alcoholic fatty liver disease-related parameters in patients with type 2 diabetes mellitus: a randomized controlled trial. BMC Endocr Disord 25, 52 (2025). https://doi.org/10.1186/s12902-025-01882-8

2. Zhang Y, Liu X, Zhang H, Wang X. Efficacy and safety of empagliflozin on nonalcoholic fatty liver disease: a systematic review and meta-analysis. Front Endocrinol 2022; doi: 10.3389/fendo.2022.836455

3. Rinella, Mary E.¹; Neuschwander-Tetri, Brent A.²; Siddiqui, Mohammad Shadab³; Abdelmalek, Manal F.⁴; Caldwell, Stephen⁵; Barb, Diana⁶; Kleiner, David E.⁷; Loomba, Rohit⁸. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology 77(5):p 1797-1835, May 2023. | DOI: 10.1097/HEP.0000000000000323

4. Kanwal, Fasiha^1,2,3; Neuschwander-Tetri, Brent A.⁴; Loomba, Rohit⁵; Rinella, Mary E.⁶. Metabolic dysfunction–associated steatotic liver disease: Update and impact of new nomenclature on the American Association for the Study of Liver Diseases practice guidance on nonalcoholic fatty liver disease. Hepatology 79(5):p 1212-1219, May 2024. | DOI: 10.1097/HEP.0000000000000670

5. Chen, Vincent L.¹; Morgan, Timothy R.^2,3; Rotman, Yaron⁴; Patton, Heather M.^5,6; Cusi, Kenneth⁷; Kanwal, Fasiha^8,9,10; Kim, W. Ray¹¹. Resmetirom therapy for metabolic dysfunction-associated steatotic liver disease: October 2024 updates to AASLD Practice Guidance. Hepatology 81(1):p 312-320, January 2025. | DOI: 10.1097/HEP.0000000000001112
6. Stratton SJ. Purposeful Sampling: Advantages and Pitfalls. Prehospital and Disaster Medicine. 2024;39(2):121-122. doi:10.1017/S1049023X24000281

Contact Information

Podcast email: whatsitworthpodcast@gmail.com

Host Information

Dr. Diana R. Langworthy, PharmD, BCPS

Clinical Associate Professor, University of Minnesota College of Pharmacy

Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital

Co-Host Information

Peyton Braun, PGY1 Pharmacy Resident

University of Minnesota Medical Center - East Bank