GLP-1 Therapy Linked to Lower Mortality in Older Adults With MASLD

Older Adults on GLP-1 Therapy Showed Lower Mortality Rates

Older adults with metabolic dysfunction-associated steatotic liver disease (MASLD) who received glucagon-like peptide-1 (GLP-1) receptor agonists experienced lower rates of death and liver complications compared to matched non-users. The retrospective cohort study evaluated electronic health records from 69 United States healthcare organizations.

Researchers analyzed outcomes from 43,930 patients aged 65 and older who began GLP-1 treatment alongside 43,930 matched individuals who did not take the drugs. The cohort had an average age of 71.8 years, and women made up 62% of the participants.

The Data Documented Reductions in Hepatic Decompensation

Patients receiving GLP-1 therapy experienced a 28% lower risk of hepatic decompensation compared to those who did not receive the medication. Hepatic decompensation marks the transition into severe, symptomatic liver failure.

The GLP-1 group also demonstrated a 45% lower risk of death from any cause during the observation period. In addition, patients taking the medications had fewer total hospitalizations over follow-up.

The Analysis Tracked Specific Safety Signals and Unchanged Outcomes

The study identified higher rates of certain medical diagnoses among patients who received GLP-1 treatments. Specifically, clinicians diagnosed more cases of osteoporosis and retinopathy in the treated cohort.

The analysis found no reduction in the incidence of myocardial infarction or stroke between the two groups. Those cardiovascular outcomes occurred at similar rates regardless of medication status.

Observational Records Cannot Establish Direct Cause and Effect

The findings come from an observational analysis of the TriNetX health records database, which limits the ability to prove that the medication directly caused the observed outcomes. While investigators matched patients across baseline lab values, medications, and underlying conditions, unmeasured factors could influence the results.

First author Dr. Tilemachos Koutouratsas noted that randomized clinical trials in older adults are necessary to confirm these patterns and clarify safety monitoring needs. Patients with liver conditions should talk to their clinician about whether GLP-1 therapies fit their broader health history.