Comparative efficacy of pharmacologic therapies for MASH in reducing liver fat content: Systematic review and network meta-analysis.

Dynamic changes in MRI proton-density-fat fraction (PDFF) are associated with MASH resolution.

MRI质子密度脂肪分数（PDFF）的动态变化与MASH的解决有关。

We aimed to determine the relative efficacy of therapeutic agents for reducing hepatic fat, assessed by MRI-PDFF.

我们的目标是确定减少肝脏脂肪的治疗剂的相对疗效，通过MRI-PDFF进行评估。

approach_and_results

In this systematic reviewand network meta-analysis, we searched MEDLINE and Embase from inception until December 26, 2023, for published randomized controlled trials comparing pharmacological interventions in patients with MASH that assessed changes in MRI-PDFF.

在这项系统评价和网络荟萃分析中，我们检索了从创刊至2023年12月26日的MEDLINE和Embase，以寻找比较药物干预措施的已发表的随机对照试验，这些试验针对的是MASH患者，并评估了MRI-PDFF的变化。

The primary outcome was the absolute change in MRI-PDFF.

主要结果是MRI-PDFF的绝对变化。

The secondary outcome was a ≥30% decline in MRI-PDFF.

次要结果是MRI-PDFF下降≥30%。

A surface under-the-curve cumulative ranking probabilities (SUCRA) analysis was performed.

进行了曲线下面积累积排名概率（SUCRA）分析。

Of 1550 records, a total of 39 randomized controlled trials (3311 participants) met the inclusion criteria.

在1550条记录中，共有39项随机对照试验（3311名参与者）符合纳入标准。

For MRI-PDFF decline at 24 weeks, aldafermin (SUCRA: 83.65), pegozafermin (SUCRA: 83.46), and pioglitazone (SUCRA: 71.67) were ranked the most effective interventions.

在24周时，对于MRI-PDFF的下降，Aldafermin（SUCRA：83.65）、Pegozafermin（SUCRA：83.46）和Pioglitazone（SUCRA：71.67）被列为最有效的干预措施。

At 24 weeks, efinopegdutide (SUCRA: 67.02), semaglutide + firsocostat (SUCRA: 62.43), and pegbelfermin (SUCRA: 61.68) were ranked the most effective interventions for achieving a ≥30% decline in MRI-PDFF.

在24周时，对于实现MRI-PDFF下降≥30%，Efinopegdutide（SUCRA：67.02）、Semaglutide + Firsocostat（SUCRA：62.43）和Pegbelfermin（SUCRA：61.68）被列为最有效的干预措施。

Conclusions

This study provides an updated, relative rank-order efficacy of therapies for MASH in reducing hepatic fat.

本研究提供了针对MASH减少肝脂肪的治疗方案的最新相对排名疗效。

These data may help inform the design and sample size calculation of future clinical trials and assist in the selection of combination therapy.

这些数据可能有助于未来临床试验的设计和样本量计算，并协助选择联合治疗方案。