Weight Loss with Canaglifozin Linked to Improvement in Nonalcoholic Fatty Liver Disease

Clinicians frequently overlook nonalcoholic fatty liver disease in their patients who have Type 2 diabetes. Yet it is estimated that approximately 70% of obese adults with diabetes have fatty liver disease, and approximately 30% to 40% of those with steatosis have the more severe form, nonalcoholic steatohepatitis. Fatty liver disease is the second most common cause of liver transplantation and puts patients at higher risk for progressive liver disease, cirrhosis and hepatocellular carcinoma. It is associated with increased insulin resistance, atherogenic dyslipidemia and cardiovascular disease.

Canaglifozin is a member of a novel class of oral antidiabetic agents called sodium glucose co-transporter-2 inhibitors, which are known to promote weight loss and decrease the risk of cardiovascular events in patients with Type 2 diabetes. Recognizing that both of these characteristics are desirable for patients with fatty liver disease, Kenneth Cusi, M.D., FACP, FACE, chief of the University of Florida College of Medicine’s Division of Endocrinology, Diabetes and Metabolism, and his research team undertook a groundbreaking clinical study to determine whether patients with Type 2 diabetes and fatty liver disease who lose weight when treated with canaglifozin also experience a reduction in liver fat and improvement in insulin secretion and action. The results of this study were recently reported in the journal Diabetes, Obesity and Metabolism.

Cusi notes, “This is the first randomized controlled trial suggesting that patients with Type 2 diabetes and fatty liver disease who lose weight when treated with canaglifozen may experience improvement in liver fat, insulin secretion and insulin action.” The study found that treatment with canaglifozen significantly improved insulin sensitivity and insulin clearance, and restored beta-cell glucose sensitivity. More patients with fatty liver disease who were treated with canaglifozin experienced weight loss of 5 percent or more compared with placebo, and the magnitude of weight loss was highly correlated with a reduction in intrahepatic triglycerides.

Cusi underscores the innovative and important work UF Health is doing in this therapeutic area and points out, “This study is valuable for all clinicians who treat patients with Type 2 diabetes who are obese.”