A new Research Institute Houston Methodist study finds that older adults with metabolic dysfunction-associated steatotic liver disease (MASLD) who received GLP-1-based treatment experienced significantly lower risks of liver disease-related complications, hospitalization and death, compared with similar patients who did not receive the treatment.

 

Researchers found that patients receiving GLP-1 therapy had a 28% lower risk of hepatic decompensation, a serious complication of advanced liver disease, and a 45% lower risk of death from any cause. They also experienced fewer hospitalizations during follow-up.

 

Published in Age and Ageing, the study was led by Eleftherios Mylonakis, M.D., Ph.D., professor of medicine at Houston Methodist Research Institute and chair of the Department of Medicine at Houston Methodist.

 

"Our findings suggest that the potential benefits of GLP-1-based treatments may extend well beyond weight loss and glycemic control," Mylonakis said. "Importantly, these findings were observed in older adults, a population that has been underrepresented in many previous studies evaluating these medications."

 

The study analyzed health records from TriNetX, a database of de-identified electronic health records from 69 U.S. healthcare organizations and compared 43,930 adults aged 65 and older who started GLP-1 therapy with 43,930 matched patients who did not receive the medications. Participants had a mean age of 71.8 years, and women represented 62% of the study population. The study applied statistical methods to ensure the groups were comparable in age, health conditions, medications and laboratory values before evaluating their outcomes.

 

“Alongside the benefits of GLP-1 treatment, we found more osteoporosis and retinopathy diagnoses in patients on GLP-1 therapy, and no reduction in heart attack or stroke,” first author Dr. Tilemachos Koutouratsas, a clinical research fellow at Houston Methodist Research Institute, said. “Randomized trials in older adults may be needed to confirm these findings and to clarify who benefits and who needs closer monitoring.”

 

MASLD is the leading cause of chronic liver disease among older adults and is associated with increased risks of cirrhosis, liver failure and death. Despite growing interest in GLP-1 therapies, evidence regarding their long-term impact on older adults remains limited.

 

Mylonakis said the associations found in the study remained consistent across multiple sensitivity analyses, but they cannot be used to establish a cause-and-effect relationship.

 

Other collaborators in the study include Mark Michael, Siddharth Das and Sophia Mylonakis from Houston Methodist Research Institute and Markos Kalligeros from Harvard Medical School.