(2.08) Effect of combination therapy with once weekly Dulaglutide and Empagliflozin on noninvasive liver scores: real world experience from India

Both type 2 diabetes mellitus and obesity are rising exponentially in India.  Insulin resistance and obesity both contributes towards liver fat deposition. Both Dulaglutide and Empagliflozin have a potential to reduce liver fat. This paper deals with the effect of combination of Dulaglutide and Empagliflozin on non-invasive scores of liver fibrosis namely AST to platelet ratio index (APRI) and fibrosis-4 score (FIB-4).

Methods:

Patients with type 2 diabetes mellitus (T2DM) treated with Dulaglutide and Empagliflozin (n=115) at our centre were included in the analysis. Body weight, BMI, blood pressure, kidney function tests, fasting lipid profile, fasting plasma glucose, post prandial plasma glucose, HbA1c, APRI and FIB-4 were measured at baseline and after a period of six months after treatment.

Results:

Significant improvement was observed in fasting blood sugars, SGOT (AST), SGPT (ALT), APRI and FIB4 (p < 0.05) (p< 0.001). Mean APRI improved from 0.39 to 0.34 (p< 0.05). APRI rule out cut off improved from 77% to 82%. Mean FIB-4 improved from 1.22 to 1.14 (p< 0.05).  FIB-4 rule out cut off was improved from 64% to 69%.  

Discussion/Conclusion:

Dulaglutide and Empagliflozin combination therapy improves liver fibrosis scores in individuals with T2DM.