Can SGLT-2 Inhibitors Improve Liver Histology in Metabolic Dysfunction–Associated Steatohepatitis?

Resmetirom, a thyroid-hormone receptor β-agonist, is the only U.S. FDA–approved drug for treating patients with metabolic dysfunction–associated steatohepatitis (MASH), but several other drug classes (e.g., glucagon-like peptide-1–receptor agonist) also have shown histologic improvement for these patients (NEJM JW Gen Med Jun 1 2025 and N Engl J Med 2025; 392:2089). Now, researchers have examined a potential role for sodium–glucose cotransporter-2 (SGLT-2) inhibitors: These drugs improve noninvasive liver parameters in patients with MASH, but their effects on liver histology were unknown.

Researchers in China randomized 154 adults with biopsy-diagnosed MASH (mean age, 35; 45% with type 2 diabetes) to receive dapagliflozin (10 mg daily) or pl…