Clinical benefits of tirzepatide in patients with steatotic liver disease and cardiometabolic dysfunction
5 affiliations
- 1Department of Internal Medicine, Chi Mei Medical Center
- 2Preventitve Medicine Division, Chi Mei Medical Center
- 3Department of Nutrition, Chi Mei Medical Center
- 4Department of Psychiatry, Chi Mei Medical Center
- 5Department of Intensive Care Medicine, Chi Mei Medical Center
Abstract
Background Metabolic dysfunction–associated steatotic liver disease affects more than 30% of adults globally, yet effective treatment options remain limited. Tirzepatide has shown promise in early clinical trials, but its real-world effectiveness with liver-related outcomes remains uncertain. Methods Using TriNetX Global Collaborative Network, adults with steatotic liver disease (SLD) and cardiometabolic dysfunction were identified between June 1, 2022, and April 25, 2025. Individuals newly prescribed tirzepatide were propensity score–matched 1:1 to controls not receiving tirzepatide. The primary outcome was major adverse liver outcomes (MALO), defined as decompensated liver events, hepatocellular carcinoma, or liver transplantation. Results Among 54,882 matched individuals, tirzepatide was associated with a lower incidence of MALO compared to the control group (HR, 0.32; 95% CI, 0.28-0.37). Tirzepatide use was associated with reductions in composite decompensated liver events (HR, 0.31; 95% CI, 0.26-0.36), esophageal variceal bleeding (HR, 0.39; 95% CI, 0.26-0.58), hepatic encephalopathy (HR, 0.27; 95% CI, 0.21-0.34), ascites-related complications (HR, 0.28; 95% CI, 0.23-0.33), hepatocellular carcinoma (HR, 0.36; 95% CI, 0.25-0.53), and liver transplantation (HR, 0.16; 95% CI, 0.08-0.33). Additionally, tirzepatide was associated with lower risks of all-cause mortality (HR, 0.22; 95% CI, 0.18-0.28), major adverse cardiac events (HR, 0.46; 95% CI, 0.40-0.52), and major adverse kidney events (HR, 0.26; 95% CI, 0.22-0.32). Conclusions In this retrospective study, tirzepatide use was associated with substantially lower risks of liver-related complications among patients with SLD and cardiometabolic dysfunction, supporting the need for prospective validation of its potential hepatic benefits.
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BibTeX
@article{shiau2026clinical,
title = {{Clinical benefits of tirzepatide in patients with steatotic liver disease and cardiometabolic dysfunction}},
author = {Bo-Wen Shiau and Wan-Hsuan Hsu and Chia-Chih Kuo and Po-Yu Huang and Ya-Wen Tsai and Jheng-Yan Wu and Ting-Hui Liu and Min-Hsiang Chuang and Chih-Cheng Lai},
journal = {Communications Medicine},
year = {2026},
month = jun,
doi = {10.1038/s43856-026-01759-4},
url = {https://doi.org/10.1038/s43856-026-01759-4},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical benefits of tirzepatide in patients with steatotic liver disease and cardiometabolic dysfunction
AU - Bo-Wen Shiau
AU - Wan-Hsuan Hsu
AU - Chia-Chih Kuo
AU - Po-Yu Huang
AU - Ya-Wen Tsai
AU - Jheng-Yan Wu
AU - Ting-Hui Liu
AU - Min-Hsiang Chuang
AU - Chih-Cheng Lai
PY - 2026
DA - 2026/06/01
JO - Communications Medicine
DO - 10.1038/s43856-026-01759-4
UR - https://doi.org/10.1038/s43856-026-01759-4
AB - Background Metabolic dysfunction–associated steatotic liver disease affects more than 30% of adults globally, yet effective treatment options remain limited. Tirzepatide has shown promise in early clinical trials, but its real-world effectiveness with liver-related outcomes remains uncertain. Methods Using TriNetX Global Collaborative Network, adults with steatotic liver disease (SLD) and cardiometabolic dysfunction were identified between June 1, 2022, and April 25, 2025. Individuals newly prescribed tirzepatide were propensity score–matched 1:1 to controls not receiving tirzepatide. The primary outcome was major adverse liver outcomes (MALO), defined as decompensated liver events, hepatocellular carcinoma, or liver transplantation. Results Among 54,882 matched individuals, tirzepatide was associated with a lower incidence of MALO compared to the control group (HR, 0.32; 95% CI, 0.28-0.37). Tirzepatide use was associated with reductions in composite decompensated liver events (HR, 0.31; 95% CI, 0.26-0.36), esophageal variceal bleeding (HR, 0.39; 95% CI, 0.26-0.58), hepatic encephalopathy (HR, 0.27; 95% CI, 0.21-0.34), ascites-related complications (HR, 0.28; 95% CI, 0.23-0.33), hepatocellular carcinoma (HR, 0.36; 95% CI, 0.25-0.53), and liver transplantation (HR, 0.16; 95% CI, 0.08-0.33). Additionally, tirzepatide was associated with lower risks of all-cause mortality (HR, 0.22; 95% CI, 0.18-0.28), major adverse cardiac events (HR, 0.46; 95% CI, 0.40-0.52), and major adverse kidney events (HR, 0.26; 95% CI, 0.22-0.32). Conclusions In this retrospective study, tirzepatide use was associated with substantially lower risks of liver-related complications among patients with SLD and cardiometabolic dysfunction, supporting the need for prospective validation of its potential hepatic benefits.
SN - 2730-664X
ER -