Combination therapy with pioglitazone/exenatide/metformin reduces the prevalence of hepatic fibrosis and steatosis: The efficacy and durability of initial combination therapy for type 2 diabetes (EDICT).

Lavynenko O, Abdul-Ghani M, Alatrach M, Puckett C, Adams J, Abdelgani S, Alkhouri N, Triplitt C, Clarke GD, Vasquez JA, Li J, Cersosimo E, Gastaldelli A, DeFronzo RA

Diabetes, obesity & metabolism9 Feb 2022Cited by 36 (Europe PMC)

PMID35014145DOI10.1111/dom.14650PepBankPUB-35014145

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Summary

The text of this summary is not shown here, because the article license does not allow reuse. Read it at the source (opens in a new tab)

Text rights: Publisher copyright. Results still quote short attributed sentences.

Results from this study12

No result from this study comes from a test of the peptide.

Studies that did not test the peptide alone12

In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Exenatide (exendin-4).

01HumanNot a test of Exenatide (exendin-4) aloneNon-randomized trialEfficacy outcome
In patients with diabetes, HbA1c was higher with metformin/exenatide/pioglitazone than conventional therapy at study end.
In plain wordsIn patients with diabetes, HbA1c was higher with metformin/exenatide/pioglitazone than conventional therapy at study end.
Peptide
Exenatide (exendin-4)
Outcome
IncreaseHbA1c
Study
n = 68
Comparator
Stepwise metformin, glipizide and glargine insulin therapy
Outcome group
Glycemic control · Metabolic and weight
Measurements
HbA1c
6.8%
triple therapy
HbA1c
6%
conventional therapy
Source sentences
Summary
At EOS, HbA1c was 6.8% and 6.0% in triple and conventional therapy groups, respectively (P = .0006).
2 context sentences(design, population, supporting numbers)
Summary · context
To compare the efficacy of triple therapy (metformin/exenatide/pioglitazone) versus stepwise conventional therapy (metformin → glipizide → glargine insulin) on liver fat content and hepatic fibrosis in newly diagnosed, drug-naïve patients with type 2 diabetes.
Summary · context
Sixty-eight patients completed the 6-year follow-up and had an end-of-study (EOS) FibroScan to provide measures of steatosis (controlled attenuation parameter [CAP] in dB/m) and fibrosis (liver stiffness measurement [LSM] in kPa);
In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Exenatide (exendin-4).
Report a problemFND-3501414501
02HumanNot a test of Exenatide (exendin-4) aloneNon-randomized trialEfficacy outcome
In patients with diabetes, grade 2/3 steatosis was less frequent with metformin/exenatide/pioglitazone than conventional therapy.
In plain wordsIn patients with diabetes, advanced steatosis was less frequent with metformin/exenatide/pioglitazone than conventional therapy.
Peptide
Exenatide (exendin-4)
Outcome
DecreaseGrade 2/3 steatosis
Study
n = 68
Comparator
Stepwise metformin, glipizide and glargine insulin therapy
Outcome group
Liver fat and liver function · Liver
Measurements
Grade 2/3 steatosis
69%
conventional therapy
Grade 2/3 steatosis
31%
triple therapy
Source sentences
Summary
Twenty-seven of 39 subjects (69%) receiving conventional therapy had grade 2/3 steatosis (CAP, FibroScan) versus nine of 29 (31%) in triple therapy (P = .0003).
2 context sentences(design, population, supporting numbers)
Summary · context
To compare the efficacy of triple therapy (metformin/exenatide/pioglitazone) versus stepwise conventional therapy (metformin → glipizide → glargine insulin) on liver fat content and hepatic fibrosis in newly diagnosed, drug-naïve patients with type 2 diabetes.
Summary · context
Sixty-eight patients completed the 6-year follow-up and had an end-of-study (EOS) FibroScan to provide measures of steatosis (controlled attenuation parameter [CAP] in dB/m) and fibrosis (liver stiffness measurement [LSM] in kPa);
In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Exenatide (exendin-4).
Report a problemFND-3501414502
03HumanNot a test of Exenatide (exendin-4) aloneNon-randomized trialEfficacy outcome
In patients with diabetes, stage 3/4 fibrosis was less frequent with metformin/exenatide/pioglitazone than conventional therapy.
In plain wordsIn patients with diabetes, advanced fibrosis was less frequent with metformin/exenatide/pioglitazone than conventional therapy.
Peptide
Exenatide (exendin-4)
Outcome
DecreaseStage 3/4 fibrosis
Study
n = 68
Comparator
Stepwise metformin, glipizide and glargine insulin therapy
Outcome group
Liver fat and liver function · Liver
Measurements
Stage 3/4 fibrosis
26%
conventional therapy
Stage 3/4 fibrosis
7%
triple therapy
Source sentences
Summary
Ten of 39 (26%) subjects receiving conventional therapy had stage 3/4 fibrosis (LSM) versus two of 29 (7%) in triple therapy (P = .04).
2 context sentences(design, population, supporting numbers)
Summary · context
To compare the efficacy of triple therapy (metformin/exenatide/pioglitazone) versus stepwise conventional therapy (metformin → glipizide → glargine insulin) on liver fat content and hepatic fibrosis in newly diagnosed, drug-naïve patients with type 2 diabetes.
Summary · context
Sixty-eight patients completed the 6-year follow-up and had an end-of-study (EOS) FibroScan to provide measures of steatosis (controlled attenuation parameter [CAP] in dB/m) and fibrosis (liver stiffness measurement [LSM] in kPa);
In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Exenatide (exendin-4).
Report a problemFND-3501414503
04HumanNot a test of Exenatide (exendin-4) aloneNon-randomized trialEfficacy outcome
In patients with diabetes, liver fat was lower with metformin/exenatide/pioglitazone than conventional therapy.
In plain wordsIn patients with diabetes, liver fat was lower with metformin/exenatide/pioglitazone than conventional therapy.
Peptide
Exenatide (exendin-4)
Outcome
DecreaseLiver fat by MRI-PDFF
Study
n = 59
Comparator
Stepwise metformin, glipizide and glargine insulin therapy
Outcome group
Liver fat and liver function · Liver
Measurements
Liver fat (MRI-PDFF)
12.9%
conventional therapy
Liver fat (MRI-PDFF)
8.8%
triple therapy
Source sentences
Summary
Conventional therapy subjects had more liver fat (MRI-PDFF) than triple therapy (12.9% vs. 8.8%, P = .03).
2 context sentences(design, population, supporting numbers)
Summary · context
To compare the efficacy of triple therapy (metformin/exenatide/pioglitazone) versus stepwise conventional therapy (metformin → glipizide → glargine insulin) on liver fat content and hepatic fibrosis in newly diagnosed, drug-naïve patients with type 2 diabetes.
Summary · context
Sixty-eight patients completed the 6-year follow-up and had an end-of-study (EOS) FibroScan to provide measures of steatosis (controlled attenuation parameter [CAP] in dB/m) and fibrosis (liver stiffness measurement [LSM] in kPa);
In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Exenatide (exendin-4).
Report a problemFND-3501414504
05HumanNot a test of Exenatide (exendin-4) aloneNon-randomized trialEfficacy outcome
In patients with diabetes, APRI decreased significantly with metformin/exenatide/pioglitazone.
In plain wordsIn patients with diabetes, APRI decreased significantly with metformin/exenatide/pioglitazone.
Peptide
Exenatide (exendin-4)
Outcome
DecreaseAPRI
Study
n = 29
Outcome group
Liver fat and liver function · Liver
Source sentences
Summary
Aspartate aminotransferase (AST) to Platelet Ratio Index (APRI), non-alcoholic fatty liver disease fibrosis score (NFS), plasma AST, and alanine aminotransferase (ALT) all decreased significantly with triple therapy,
2 context sentences(design, population, supporting numbers)
Summary · context
To compare the efficacy of triple therapy (metformin/exenatide/pioglitazone) versus stepwise conventional therapy (metformin → glipizide → glargine insulin) on liver fat content and hepatic fibrosis in newly diagnosed, drug-naïve patients with type 2 diabetes.
Summary · context
Sixty-eight patients completed the 6-year follow-up and had an end-of-study (EOS) FibroScan to provide measures of steatosis (controlled attenuation parameter [CAP] in dB/m) and fibrosis (liver stiffness measurement [LSM] in kPa);
In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Exenatide (exendin-4).
Report a problemFND-3501414509
06HumanNot a test of Exenatide (exendin-4) aloneNon-randomized trialEfficacy outcome
In patients with diabetes, NFS decreased significantly with metformin/exenatide/pioglitazone.
In plain wordsIn patients with diabetes, NFS decreased significantly with metformin/exenatide/pioglitazone.
Peptide
Exenatide (exendin-4)
Outcome
DecreaseNFS
Study
n = 29
Outcome group
Liver fat and liver function · Liver
Source sentences
Summary
Aspartate aminotransferase (AST) to Platelet Ratio Index (APRI), non-alcoholic fatty liver disease fibrosis score (NFS), plasma AST, and alanine aminotransferase (ALT) all decreased significantly with triple therapy,
2 context sentences(design, population, supporting numbers)
Summary · context
To compare the efficacy of triple therapy (metformin/exenatide/pioglitazone) versus stepwise conventional therapy (metformin → glipizide → glargine insulin) on liver fat content and hepatic fibrosis in newly diagnosed, drug-naïve patients with type 2 diabetes.
Summary · context
Sixty-eight patients completed the 6-year follow-up and had an end-of-study (EOS) FibroScan to provide measures of steatosis (controlled attenuation parameter [CAP] in dB/m) and fibrosis (liver stiffness measurement [LSM] in kPa);
In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Exenatide (exendin-4).
Report a problemFND-3501414510
07HumanNot a test of Exenatide (exendin-4) aloneNon-randomized trialEfficacy outcome
In patients with diabetes, plasma AST decreased significantly with metformin/exenatide/pioglitazone.
In plain wordsIn patients with diabetes, plasma AST decreased significantly with metformin/exenatide/pioglitazone.
Peptide
Exenatide (exendin-4)
Outcome
DecreaseAST
Study
n = 29
Outcome group
Liver fat and liver function · Liver
Source sentences
Summary
Aspartate aminotransferase (AST) to Platelet Ratio Index (APRI), non-alcoholic fatty liver disease fibrosis score (NFS), plasma AST, and alanine aminotransferase (ALT) all decreased significantly with triple therapy,
2 context sentences(design, population, supporting numbers)
Summary · context
To compare the efficacy of triple therapy (metformin/exenatide/pioglitazone) versus stepwise conventional therapy (metformin → glipizide → glargine insulin) on liver fat content and hepatic fibrosis in newly diagnosed, drug-naïve patients with type 2 diabetes.
Summary · context
Sixty-eight patients completed the 6-year follow-up and had an end-of-study (EOS) FibroScan to provide measures of steatosis (controlled attenuation parameter [CAP] in dB/m) and fibrosis (liver stiffness measurement [LSM] in kPa);
In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Exenatide (exendin-4).
Report a problemFND-3501414511
08HumanNot a test of Exenatide (exendin-4) aloneNon-randomized trialEfficacy outcome
In patients with diabetes, ALT decreased significantly with metformin/exenatide/pioglitazone.
In plain wordsIn patients with diabetes, ALT decreased significantly with metformin/exenatide/pioglitazone.
Peptide
Exenatide (exendin-4)
Outcome
DecreaseALT
Study
n = 29
Outcome group
Liver fat and liver function · Liver
Source sentences
Summary
Aspartate aminotransferase (AST) to Platelet Ratio Index (APRI), non-alcoholic fatty liver disease fibrosis score (NFS), plasma AST, and alanine aminotransferase (ALT) all decreased significantly with triple therapy,
2 context sentences(design, population, supporting numbers)
Summary · context
To compare the efficacy of triple therapy (metformin/exenatide/pioglitazone) versus stepwise conventional therapy (metformin → glipizide → glargine insulin) on liver fat content and hepatic fibrosis in newly diagnosed, drug-naïve patients with type 2 diabetes.
Summary · context
Sixty-eight patients completed the 6-year follow-up and had an end-of-study (EOS) FibroScan to provide measures of steatosis (controlled attenuation parameter [CAP] in dB/m) and fibrosis (liver stiffness measurement [LSM] in kPa);
In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Exenatide (exendin-4).
Report a problemFND-3501414512
09HumanNot a test of Exenatide (exendin-4) aloneNon-randomized trialOther
In patients receiving triple therapy, the decrease in plasma AST correlated with steatosis and fibrosis severity at study end.
In plain wordsIn patients receiving triple therapy, the drop in AST was linked to steatosis and fibrosis severity at study end.
Peptide
Exenatide (exendin-4)
Outcome
Direction not reportedAST change association with steatosis and fibrosis severity
Study
n: not reported in source
Outcome group
Liver fat and liver function · Liver
Source sentences
Summary
but only the decrease in plasma AST and ALT correlated with the severity of steatosis and fibrosis at EOS.
2 context sentences(design, population, supporting numbers)
Summary · context
To compare the efficacy of triple therapy (metformin/exenatide/pioglitazone) versus stepwise conventional therapy (metformin → glipizide → glargine insulin) on liver fat content and hepatic fibrosis in newly diagnosed, drug-naïve patients with type 2 diabetes.
Summary · context
Sixty-eight patients completed the 6-year follow-up and had an end-of-study (EOS) FibroScan to provide measures of steatosis (controlled attenuation parameter [CAP] in dB/m) and fibrosis (liver stiffness measurement [LSM] in kPa);
In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Exenatide (exendin-4).
Report a problemFND-3501414513
10HumanNot a test of Exenatide (exendin-4) aloneNon-randomized trialOther
In patients receiving triple therapy, the decrease in plasma ALT correlated with steatosis and fibrosis severity at study end.
In plain wordsIn patients receiving triple therapy, the drop in ALT was linked to steatosis and fibrosis severity at study end.
Peptide
Exenatide (exendin-4)
Outcome
Direction not reportedALT change association with steatosis and fibrosis severity
Study
n: not reported in source
Outcome group
Liver fat and liver function · Liver
Source sentences
Summary
but only the decrease in plasma AST and ALT correlated with the severity of steatosis and fibrosis at EOS.
2 context sentences(design, population, supporting numbers)
Summary · context
To compare the efficacy of triple therapy (metformin/exenatide/pioglitazone) versus stepwise conventional therapy (metformin → glipizide → glargine insulin) on liver fat content and hepatic fibrosis in newly diagnosed, drug-naïve patients with type 2 diabetes.
Summary · context
Sixty-eight patients completed the 6-year follow-up and had an end-of-study (EOS) FibroScan to provide measures of steatosis (controlled attenuation parameter [CAP] in dB/m) and fibrosis (liver stiffness measurement [LSM] in kPa);
In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Exenatide (exendin-4).
Report a problemFND-3501414515
11HumanNot a test of Exenatide (exendin-4) aloneNon-randomized trialOther
In patients receiving triple therapy, the decrease in APRI did not correlate with steatosis or fibrosis severity at study end.
In plain wordsIn patients receiving triple therapy, the drop in APRI was not linked to steatosis or fibrosis severity at study end.
Peptide
Exenatide (exendin-4)
Outcome
No significant changeAPRI change association with steatosis and fibrosis severity
Study
n: not reported in source
Outcome group
Liver fat and liver function · Liver
Source sentences
Summary
Aspartate aminotransferase (AST) to Platelet Ratio Index (APRI), non-alcoholic fatty liver disease fibrosis score (NFS), plasma AST, and alanine aminotransferase (ALT) all decreased significantly with triple therapy,
2 context sentences(design, population, supporting numbers)
Summary · context
but only the decrease in plasma AST and ALT correlated with the severity of steatosis and fibrosis at EOS.
Summary · context
To compare the efficacy of triple therapy (metformin/exenatide/pioglitazone) versus stepwise conventional therapy (metformin → glipizide → glargine insulin) on liver fat content and hepatic fibrosis in newly diagnosed, drug-naïve patients with type 2 diabetes.
In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Exenatide (exendin-4).
Report a problemFND-3501414517
12HumanNot a test of Exenatide (exendin-4) aloneNon-randomized trialOther
In patients receiving triple therapy, the decrease in NFS did not correlate with steatosis or fibrosis severity at study end.
In plain wordsIn patients receiving triple therapy, the drop in NFS was not linked to steatosis or fibrosis severity at study end.
Peptide
Exenatide (exendin-4)
Outcome
No significant changeNFS change association with steatosis and fibrosis severity
Study
n: not reported in source
Outcome group
Liver fat and liver function · Liver
Source sentences
Summary
Aspartate aminotransferase (AST) to Platelet Ratio Index (APRI), non-alcoholic fatty liver disease fibrosis score (NFS), plasma AST, and alanine aminotransferase (ALT) all decreased significantly with triple therapy,
2 context sentences(design, population, supporting numbers)
Summary · context
but only the decrease in plasma AST and ALT correlated with the severity of steatosis and fibrosis at EOS.
Summary · context
To compare the efficacy of triple therapy (metformin/exenatide/pioglitazone) versus stepwise conventional therapy (metformin → glipizide → glargine insulin) on liver fat content and hepatic fibrosis in newly diagnosed, drug-naïve patients with type 2 diabetes.
In this study, Exenatide (exendin-4) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Exenatide (exendin-4).
Report a problemFND-3501414519

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Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
22 Oct 2026, 02:26 UTC
Study results updated
Version 1
21 Oct 2026, 18:59 UTC
First added · source update from Europe PMC

Subjects

Terms as the source lists them.

Publication types

MeSH terms

Keywords

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