Table 2

Anti-diabetic medications in MASLD and MASH

Medication	Liver enzymes	Hepatic steatosis	Liver stiffness	MASH	Fibrosis progression	Fibrosis regression
Tirzepatide71 72	Beneficial	Beneficial	Beneficial	Beneficial	Possible benefit	Possible benefit
GLP-1 RA62–66 68 69	Beneficial	Beneficial	Beneficial	Beneficial	Possible benefit*	Possible benefit*
Pioglitazone44 46–51	Beneficial	Beneficial	Beneficial	Beneficial	Possible benefit	Neutral
SGLT2 inhibitors92–101	Beneficial	Beneficial	Beneficial	Unknown	Unknown	Unknown
Insulin102–104	Beneficial	Beneficial	Unknown	Unknown	Unknown	Unknown
Metformin105–107	Beneficial	Neutral	Neutral	Neutral	Neutral	Neutral
DPP-4 Inhibitors105–107	Neutral	Unknown	Unknown	Unknown	Unknown	Unknown
Sulfonylureas13	Neutral	Unknown	Unknown	Unknown	Unknown	Unknown

*Histological evidence for semaglutide.68
GLP-1 RA, glucagon-like peptide-1 receptor agonists; MASH, metabolic dysfunction-associated steatohepatitis; MASLD, metabolic dysfunction-associated steatotic liver disease; SGLT2, sodium-glucose transporter 2.