Efruxifermin in patients with metabolic dysfunction-associated steatohepatitis: A GRADE-assessed systematic review and meta-analysis

作者：Umama Alam, Shree Rath, Muhammad Ansab, Aamna Kashif, Furqan Ahmad Sethi, Hafiza Tooba Siddiqui, Zain Afridi, Muhammad Burhan, Muhammad Abdullah Ali, Abdul Moiz, Zaryab Bacha, Ahmad Khan, Raheel Ahmed, Monsurah Bisola Alatise, Kamil Ahmad Kamil · 发表于：World Journal of Hepatology · 年份：2026 · DOI：10.4254/wjh.v18.i3.115411 · 研究领域：Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation、Drug-Induced Hepatotoxicity and Protection

BACKGROUND Metabolic-associated steatohepatitis (MASH) is a prevalent metabolic condition affecting one-third of adults worldwide. AIM To evaluate the safety and efficacy of efruxifermin in patients with compensated MASH cirrhosis. METHODS A comprehensive search was conducted up to May 2025. Outcomes assessed included fibrosis improvement, MASH resolution, liver stiffness, and metabolic indices such as high-density lipoprotein cholesterol and homeostatic model assessment of insulin resistance. Adverse events were also analyzed. Statistical analysis was conducted using a random-effects model, with results presented as risk ratios or mean differences along with 95% confidence intervals and P -values. RESULTS The meta-analysis included five randomized controlled trials involving 450 patients. Efruxifermin led to significant improvement in fibrosis without worsening of MASH and MASH resolution without worsening of fibrosis (risk ratio = 3.00, 95% confidence interval: 2.05-4.38). Further, a significantly higher patients noted reduction in aspartate aminotransferase, alanine aminotransferase and homeostatic model assessment of insulin resistance levels, and increased high-density lipoprotein cholesterol. While efruxifermin was generally well-tolerated, gastrointestinal side effects such as nausea and diarrhea were more frequent in the efruxifermin group. The incidence of serious adverse events was comparable between groups. CONCLUSION Efruxifermin demonstrated significant efficacy ...