Three different classes of antihyperglycaemic drugs have shown promise in improving liver function in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, according to a systematic review.

Pending larger phase III trials, peroxisome proliferator-activated receptor (PPAR) agonists, glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter 2 (SGLT2) inhibitors could become vital treatment options for these conditions, European researchers say.

Writing in The Lancet Gastroenterology and Hepatology, the team analysed data from 25 studies examining the efficacy of these drugs for treating non-alcoholic fatty liver disease (NAFLD) in 2600 adults with or without type 2 diabetes (mean age 52).

Pioglitazone, lanifibranor and the GLP-1 receptor agonists were found to improve individual histological features of non-alcoholic steatohepatitis (NASH) — such as steatosis, ballooning and lobular inflammation — or resolved NASH without worsening fibrosis.