Effect of ipragliflozin on liver enzymes in type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is estimated to affect upto 70–80% of people with type 2 diabetes mellitus (T2DM). Although several anti-hyperglycemic drugs have been shown to be effective in such patients, there remains an unmet need for newer drugs. The objective of this meta-analysis was to analyze the effect of ipragliflozin on aspartate aminotransferase (AST), alanine transaminase (ALT), and gamma-glutamyl transpeptidase (GGT) levels in patients with T2DM. A literature search on electronic databases was conducted to identify potential randomized clinical trials (RCT) as per predetermined study selection criteria. Mean difference (MD) was calculated using Cochrane review manager. Twelve studies were included in the meta-analysis, including 1349 subjects. Compared to the control group, ipragliflozin as a monotherapy showed a significant reduction in levels of ALT at week 12 (<i>p</i> = 0.02) and at week 24 (<i>p</i> = 0.007), GGT at week 12 (<i>p</i> &lt; 0.00001). Ipragliflozin as an add-on therapy showed significant reduction in levels of AST at week 24 (<i>p</i> &lt; 0.00001), ALT at week 12 (<i>p</i> = 0.002), ALT at week 24 (<i>p</i> &lt; 0.00001), and GGT at week 24 (<i>p</i> &lt; 0.00001). Findings suggest the beneficial effects of ipragliflozin on liver enzymes. Further large-scale RCTs are required to confirm ipragliflozin’s role for liver-related conditions in T2DM.