Prospects of using sodium-glucose co-transporter-2 (SGLT-2) inhibitors in patients with metabolic-associated fatty liver disease (MAFLD)

Abstract

Metabolic dysfunction-associated fatty liver disease (MAFLD) is recognised worldwide as a serious health problem, given the global prevalence of about 30% of the world population and high incidence of nonalcoholic steatohepatitis (NASH), which has reached epidemic levels in the 12%-21% of people with type 2 diabetes mellitus (DM). In patients with comorbidity of type 2 DM, atherosclerotic cardiovascular disease (ASCVD), visceral obesity (VO), insulin resistance syndrome (IRS) the frequency of MAFLD is 70%. For this reason a modern, complex and patient-oriented approach to the treatment of MAFLD is of paramount importance, which can simultaneously treat several disorders by preventing interaction between underlying causes of NASH in patients with type 2 DM. The growing burden of morbidity, therapeutic inertia of primary care physicians and highly specialized gastroenterologists, endocrinologists regarding early diagnostics of NASH in people with type 2 DM and VO often leads to incomplete treatment of MAFLD manifestations. Nowadays SGLT-2 inhibitors present an innovative class of hypoglycemic drugs which have improved the glucose-centric approach to the therapy of type 2 DM combined with organ-protective properties. The data obtained from epoch-making controlled clinical trials and clinical practice presents an opportunity of new clinical horizons regarding the hepatoprotective properties of SGLT-2 inhibitors. In this review the efficacy, safety and prospects of using SGLT-2 in patients with MAFLD were evaluated.