A drug commonly used to treat type 2 diabetes may also help improve a serious liver condition, according to a new clinical trial from China published in The BMJ. The drug, dapagliflozin, is part of a class of medications called SGLT-2 inhibitors, which help lower blood sugar by removing extra glucose through the urine.
But in this study, it was found to benefit patients with metabolic dysfunction-associated steatohepatitis (MASH)—a condition where fat builds up in the liver, causing inflammation and scarring.
MASH is becoming increasingly common. It affects more than 5% of adults worldwide and over 30% of people who have diabetes or obesity. If left untreated, MASH can worsen over time, leading to severe liver damage, including cirrhosis, in up to one in four people.
While earlier studies suggested that SGLT-2 inhibitors might help reduce fat in the liver and improve liver function, this is the first clinical trial to look specifically at their effects in patients with MASH.
The trial involved 154 adults, mostly men with an average age of 35, all diagnosed with MASH through a liver biopsy. About half of the participants also had type 2 diabetes, and nearly all had some level of liver scarring, or fibrosis.
Participants were randomly assigned to take either 10 mg of dapagliflozin or a placebo (a pill with no active medicine) once a day for 48 weeks. They also received basic health education twice during the year. Researchers monitored changes in body weight, blood sugar, liver enzymes, and other health markers.
At the end of the study, participants had another liver biopsy to assess changes. The results were encouraging. In the dapagliflozin group, 53% of participants showed improvement in MASH without their liver scarring getting worse.
In the placebo group, only 30% improved. Also, nearly a quarter of those taking dapagliflozin had complete resolution of MASH (meaning the disease was no longer detectable) without worsening fibrosis, compared to only 8% in the placebo group.
Liver scarring also improved more often in the dapagliflozin group. In 45% of patients taking the drug, fibrosis improved without their MASH getting worse, compared to just 20% of those taking the placebo.
Importantly, the drug appeared to be safe. Only one person in the dapagliflozin group stopped taking the medication because of side effects, compared to two people in the placebo group.
The researchers did note some limitations. Since the trial was conducted in China, the results may not apply to all populations, especially since most participants were young men. Women and older patients were under-represented. Still, the results remained consistent after further analysis, suggesting the findings are reliable.
In summary, this study provides early evidence that dapagliflozin may help treat both liver inflammation and scarring in people with MASH. Larger and longer-term studies are still needed to confirm these benefits and to see how well they apply to broader groups of patients.
Experts in a related editorial say the future looks bright for treating MASH. More medications are being studied, and over time, doctors may be able to choose treatments based on each patient’s unique needs. Ideally, these future treatments will also help protect the heart, be safe to use, and be available to people from all walks of life.
For now, dapagliflozin offers a promising new option for a condition that has had few effective treatments—giving hope to patients with both diabetes and liver disease.
If you care about diabetes, please read studies about the cooking connection between potatoes and diabetes, and low calorie diets may help reverse type 2 diabetes.
For more health information, please see recent studies about protein power: a new ally in diabetes management, and pineapple and diabetes: A sweet surprise.
The research findings can be found in The BMJ.
Copyright © 2025 Knowridge Science Report. All rights reserved.
