• Posted June 6, 2025

Diabetes Drug Effective For Fatty Liver Disease

A repurposed diabetes drug can be an effective tool against fatty liver disease, a new clinical trial has found.

Dapagliflozin helped people reduce fat levels in their liver and avoid liver scarring that comes with the condition, which doctors call metabolic dysfunction-associated steatohepatitis, or MASH, researchers reported June 4 in The BMJ.

In fact, about 23% of people taking dapagliflozin experienced a complete resolution of their fatty liver disease compared to 8% of people given a placebo, results show.

“We found that 48 weeks of treatment with dapagliflozin led to a significant MASH improvement without worsening of [scarring], as compared with placebo,” concluded a team led by Huijie Zhang, director of endocrinology and metabolism at Nanfang Hospital at Southern Medical University in Guangzhou, China.

Dapagliflozin is a sodium glucose cotransporter 2 (SGLT2) inhibitor, a type of diabetes drug that lowers blood sugar by increasing the amount of glucose that’s secreted in urine.

Fatty liver disease affects more than 5% of adults worldwide and more than 30% of people with diabetes or obesity, researchers said in background notes. The scarring it causes can lead to liver failure or liver cancer, according to the Cleveland Clinic.

Some prior studies had reported that SGLT2 inhibitors might improve liver fat content in people with fatty liver disease, but this is the first clinical trial to test their use in patients with biopsies that confirmed they have MASH, researchers said.

In the study, 154 people with fatty liver disease were randomly assigned to take either dapagliflozin pills or a placebo daily for 48 weeks. The patients were treated at six hospitals in China between Novemebr 2018 and March 2023.

Nearly all of the patients (97%) had liver scarring because of their fatty liver disease, and about half (45%) also had type 2 diabetes.

By the end, about 53% of patients taking dapagliflozin showed improvement in their fatty liver disease without any worsening of their liver scarring, compared with 30% in the placebo group, results show.

And in nearly a quarter (23%) the fatty liver disease went away completely, compared with 8% of placebo patients, researchers say.

Liver scarring also improved in 45% of the dapagliflozin patients, versus 20% of those on placebo.

Patients did not suffer any significant side effects from the drug, researchers reported.

“These results support the potential for dapagliflozin to provide benefit to patients with MASH and liver (scarring),” they concluded.

More information

The Cleveland Clinic has more about fatty liver disease.

SOURCES: The BMJ, news release, June 4, 2025; The BMJ, study, June 4, 2025