Efficacy of tirzepatide versus SGLT2 inhibitors in metabolic dysfunction-associated steatotic liver disease (MASLD): a multicenter propensity-matched real-world study.

Khalil I, Sarker P, Nur N, Hossain MI, Khalid AA, Al-Badri SG, Akter MM, Das M, Rahman MT

Hepatology international3 Jul 2026

PMID42397506DOI10.1007/s12072-026-11122-3PepBankPUB-42397506

Publisher page PubMedAsk about this study

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 study13

13 results from studies that gave the peptide. 13 results from people.

01HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, tirzepatide was associated with lower 1-year all-cause mortality than SGLT2 inhibitors (hazard ratio 0.328).
In plain wordsIn adults with fatty liver disease, tirzepatide use was linked to fewer deaths at 1 year than SGLT2 inhibitor use.
Peptide
Tirzepatide
Outcome
DecreaseAll-cause mortality at 1 year
Study
n = 43,743
Comparator
SGLT2 inhibitors
Analysis
Primary
Outcome group
Mortality · Whole body
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Measurements
Hazard ratio
0.328 ratio
1-year all-cause mortality
Source sentences
Summary
At 1-year follow-up (n = 43,743 per group), all-cause mortality events were 144 (cumulative incidence 0.48%, KM event-free survival 99.52%) with tirzepatide versus 533 (1.38%, 98.62%) with SGLT2i (HR 0.328, 95% CI 0.272-0.394; log-rank p < 0.0001).
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750601
02HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, tirzepatide was associated with fewer all-cause hospitalizations at 1 year than SGLT2 inhibitors (hazard ratio 0.460).
In plain wordsIn adults with fatty liver disease, tirzepatide use was linked to fewer hospital stays at 1 year than SGLT2 inhibitor use.
Peptide
Tirzepatide
Outcome
DecreaseAll-cause hospitalization at 1 year
Study
n = 43,743
Comparator
SGLT2 inhibitors
Analysis
Primary
Outcome group
Intensive care and hospital outcomes · Whole body
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Measurements
Hazard ratio
0.46 ratio
1-year hospitalization
Source sentences
Summary
All-cause hospitalization occurred in 3033 versus 7143 (HR 0.460, 95% CI 0.441-0.480).
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750602
03HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, tirzepatide was associated with fewer major adverse cardiovascular events at 1 year than SGLT2 inhibitors (hazard ratio 0.506).
In plain wordsIn adults with fatty liver disease, tirzepatide use was linked to fewer major heart events at 1 year than SGLT2 inhibitor use.
Peptide
Tirzepatide
Outcome
DecreaseMACE at 1 year
Study
n = 43,743
Comparator
SGLT2 inhibitors
Analysis
Primary
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Measurements
Hazard ratio
0.506 ratio
1-year MACE
Source sentences
Summary
MACE events were 1064 versus 2376 (HR 0.506, 95%CI 0.471-0.544).
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750603
04HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, tirzepatide was associated with fewer major adverse liver outcomes at 1 year than SGLT2 inhibitors (hazard ratio 0.379).
In plain wordsIn adults with fatty liver disease, tirzepatide use was linked to fewer major liver events at 1 year than SGLT2 inhibitor use.
Peptide
Tirzepatide
Outcome
DecreaseMajor adverse liver outcomes at 1 year
Study
n = 43,743
Comparator
SGLT2 inhibitors
Analysis
Primary
Outcome group
Liver fat and liver function · Liver
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Measurements
Hazard ratio
0.379 ratio
1-year MALO
Source sentences
Summary
MALO events were 149 versus 465 (HR 0.379, 95% CI 0.315-0.456).
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750604
05HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, major adverse kidney events did not differ significantly between tirzepatide and SGLT2 inhibitors at 1 year.
In plain wordsIn adults with fatty liver disease, major kidney events were not significantly different between tirzepatide and SGLT2 inhibitors at 1 year.
Peptide
Tirzepatide
Outcome
No significant changeMajor adverse kidney events at 1 year
Study
n = 43,743
Comparator
SGLT2 inhibitors
Analysis
Primary
Outcome group
Kidney function · Kidney and urinary
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Source sentences
Summary
while MAKE, varices, and hepatic encephalopathy showed no significant differences.
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750607
06HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, tirzepatide was associated with lower 3-year all-cause mortality than SGLT2 inhibitors (hazard ratio 0.374).
In plain wordsIn adults with fatty liver disease, tirzepatide use was linked to fewer deaths at 3 years than SGLT2 inhibitor use.
Peptide
Tirzepatide
Outcome
DecreaseAll-cause mortality at 3 years
Study
n = 39,838
Comparator
SGLT2 inhibitors
Analysis
Primary
Outcome group
Mortality · Whole body
Studied dose
Dose not stated · 3 yearsAs given in this study (human).
Measurements
Hazard ratio
0.374 ratio
3-year all-cause mortality
Source sentences
Summary
mortality 208 versus 963 (HR 0.374, 95% CI 0.321-0.436)
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750610
07HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, tirzepatide was associated with fewer all-cause hospitalizations at 3 years than SGLT2 inhibitors (hazard ratio 0.528).
In plain wordsIn adults with fatty liver disease, tirzepatide use was linked to fewer hospital stays at 3 years than SGLT2 inhibitor use.
Peptide
Tirzepatide
Outcome
DecreaseAll-cause hospitalization at 3 years
Study
n = 39,838
Comparator
SGLT2 inhibitors
Analysis
Primary
Outcome group
Intensive care and hospital outcomes · Whole body
Studied dose
Dose not stated · 3 yearsAs given in this study (human).
Measurements
Hazard ratio
0.528 ratio
3-year hospitalization
Source sentences
Summary
hospitalization 3723 versus 9548 (HR 0.528, 95%CI 0.508-0.549)
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750611
08HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, tirzepatide was associated with fewer major adverse cardiovascular events at 3 years than SGLT2 inhibitors (hazard ratio 0.545).
In plain wordsIn adults with fatty liver disease, tirzepatide use was linked to fewer major heart events at 3 years than SGLT2 inhibitor use.
Peptide
Tirzepatide
Outcome
DecreaseMACE at 3 years
Study
n = 39,838
Comparator
SGLT2 inhibitors
Analysis
Primary
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated · 3 yearsAs given in this study (human).
Measurements
Hazard ratio
0.545 ratio
3-year MACE
Source sentences
Summary
MACE 1260 versus 3282 (HR 0.545, 95%CI 0.510-0.582)
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750612
09HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, tirzepatide was associated with fewer major adverse liver outcomes at 3 years than SGLT2 inhibitors (hazard ratio 0.478).
In plain wordsIn adults with fatty liver disease, tirzepatide use was linked to fewer major liver events at 3 years than SGLT2 inhibitor use.
Peptide
Tirzepatide
Outcome
DecreaseMajor adverse liver outcomes at 3 years
Study
n = 39,838
Comparator
SGLT2 inhibitors
Analysis
Primary
Outcome group
Liver fat and liver function · Liver
Studied dose
Dose not stated · 3 yearsAs given in this study (human).
Measurements
Hazard ratio
0.478 ratio
3-year MALO
Source sentences
Summary
MALO 220 versus 726 (HR 0.478, 95%CI 0.410-0.558)
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750613
10HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, hepatic failure favored tirzepatide over SGLT2 inhibitors at 1 year.
In plain wordsIn adults with fatty liver disease, liver failure was less common with tirzepatide than with SGLT2 inhibitors at 1 year.
Peptide
Tirzepatide
Outcome
DecreaseHepatic failure at 1 year
Study
n = 43,743
Comparator
SGLT2 inhibitors
Outcome group
Liver fat and liver function · Liver
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Source sentences
Summary
Hepatic failure and ascites also favored tirzepatide
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750605
11HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, ascites favored tirzepatide over SGLT2 inhibitors at 1 year.
In plain wordsIn adults with fatty liver disease, fluid build-up in the belly was less common with tirzepatide than with SGLT2 inhibitors at 1 year.
Peptide
Tirzepatide
Outcome
DecreaseAscites at 1 year
Study
n = 43,743
Comparator
SGLT2 inhibitors
Outcome group
Liver fat and liver function · Liver
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Source sentences
Summary
Hepatic failure and ascites also favored tirzepatide
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750606
12HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, varices did not differ significantly between tirzepatide and SGLT2 inhibitors at 1 year.
In plain wordsIn adults with fatty liver disease, enlarged veins (varices) were not significantly different between tirzepatide and SGLT2 inhibitors at 1 year.
Peptide
Tirzepatide
Outcome
No significant changeVarices at 1 year
Study
n = 43,743
Comparator
SGLT2 inhibitors
Outcome group
Liver fat and liver function · Liver
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Source sentences
Summary
while MAKE, varices, and hepatic encephalopathy showed no significant differences.
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750608
13HumanObservational studyEfficacy outcome
In adults with MASLD and metabolic comorbidity, hepatic encephalopathy did not differ significantly between tirzepatide and SGLT2 inhibitors at 1 year.
In plain wordsIn adults with fatty liver disease, liver-related brain problems were not significantly different between tirzepatide and SGLT2 inhibitors at 1 year.
Peptide
Tirzepatide
Outcome
No significant changeHepatic encephalopathy at 1 year
Study
n = 43,743
Comparator
SGLT2 inhibitors
Outcome group
Liver fat and liver function · Liver
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Source sentences
Summary
while MAKE, varices, and hepatic encephalopathy showed no significant differences.
1 context sentence(design, population, supporting numbers)
Summary · context
In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity.
Report a problemFND-4239750609

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

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
12 Oct 2026, 12:10 UTC
Study results updated
Version 1
9 Oct 2026, 03:07 UTC
First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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Efficacy of tirzepatide versus SGLT2 inhibitors in metabolic dysfunction-associated steatotic liver disease (MASLD): a multicenter propensity-matched real-world study.

Summary

Results from this study13

Version history

Subjects

Publication types

MeSH terms

Keywords