Comparison of pharmacological therapies in metabolic dysfunction-associated steatohepatitis for fibrosis regression and MASH resolution: Systematic review and network meta-analysis.

With the advent of multiple therapeutic targets in late-phase clinical drug development for MASH, there is a knowledge gap to better understand the comparative efficacy of various pharmacological agents.

随着晚期临床药物开发中针对MASH的多种治疗靶点的出现，存在一个知识空白，需要更好地理解各种药物的相对疗效。

We conducted an updated network meta-analysisto evaluate the relative rank order of the different pharmacological agents for both fibrosis regression and MASH resolution.

我们进行了一项最新的网络荟萃分析，以评估不同药物对纤维化逆转和MASH（代谢相关脂肪性肝病）解决的相对排名顺序。

approach_and_results

We searched PubMed and Embase databases from January 1, 2020 to December 1, 2024, for published randomized controlled trials comparing pharmacological interventions in patients with biopsy-proven MASH.

我们从2020年1月1日至2024年12月1日，对PubMed和Embase数据库进行了检索，以寻找比较药物干预措施的已发表随机对照试验，这些试验的对象是经活组织检查证实为MASH的患者。

The co-primary endpoints were fibrosis improvement ≥1 stage without MASH worsening and MASH resolution without worsening fibrosis.

主要终点是纤维化改善≥1期而不伴有MASH恶化，以及MASH消退而不伴有纤维化恶化。

We conducted surface under the cumulative ranking curve (SUCRA) analysis.

我们进行了累积排名曲线下面积（SUCRA）分析。

A total of 29 randomized controlled trials (n=9324) were included.

共纳入了29项随机对照试验（n=9324）。

Pegozafermin, cilofexor + firsocostat, denifanstat, survodutide, obeticholic acid, tirzepatide, resmetirom, and semaglutide were significantly better than placebo in achieving fibrosis regression without worsening MASH.

Pegozafermin、cilofexor + firsocostat、denifanstat、survodutide、obeticholic acid、tirzepatide、resmetirom和semaglutide在实现纤维化逆转且不加重MASH方面显著优于安慰剂。

Pegozafermin (SUCRA: 79.92), cilofexor + firsocostat (SUCRA: 71.38), and cilofexor + selonsertib (SUCRA: 69.11) were ranked the most effective interventions.

Pegozafermin（SUCRA：79.92）、cilofexor + firsocostat（SUCRA：71.38）和cilofexor + selonsertib（SUCRA：69.11）被评为最有效的干预措施。

Pegozafermin, survodutide, tirzepatide, efruxifermin, liraglutide, vitamin E + pioglitazone, resmetirom, semaglutide, pioglitazone, denifanstat, semaglutide, and lanifibranor were significantly better than placebo in achieving MASH resolution without worsening fibrosis.

Pegozafermin、survodutide、tirzepatide、efruxifermin、liraglutide、维生素E + pioglitazone、resmetirom、semaglutide、pioglitazone、denifanstat、semaglutide和lanifibranor在实现MASH消退而不加重纤维化方面显著优于安慰剂。

Pegozafermin (SUCRA: 91.75), survodutide (SUCRA: 90.87), and tirzepatide (SUCRA: 84.70) were ranked the most effective interventions for achieving MASH resolution without worsening fibrosis.

Pegozafermin（SUCRA: 91.75）、survodutide（SUCRA: 90.87）和tirzepatide（SUCRA: 84.70）被列为实现MASH消退而不加重纤维化的最有效干预措施。

Conclusions

This study provides updated rank-order efficacy of MASH pharmacological therapies for fibrosis regression and MASH resolution.

本研究提供了MASH药物治疗的最新排名疗效，用于纤维化回退和MASH消退。

These data are helpful to inform practice and clinical trial design.

这些数据有助于指导实践和临床试验设计。