Nat Med

Metabolic surgery improves liver outcomes in MASH-related cirrhosis

January 29, 2025

Metabolic surgery may offer a safe and effective therapeutic option for patients with compensated cirrhosis due to metabolic dysfunction-associated steatohepatitis (MASH), significantly reducing the risk of major adverse liver outcomes (MALO) and decompensated cirrhosis.

Study design: The SPECCIAL observational study compared metabolic surgery and nonsurgical treatment in 168 patients with obesity and compensated MASH-related cirrhosis. Using doubly robust estimation, the study balanced key baseline characteristics between 62 surgical patients and 106 nonsurgical controls, with a mean follow-up of 10.0 ± 4.5 years.

Results: The 15-year cumulative incidence of MALO was significantly lower in the surgical group (20.9%) compared with the nonsurgical group (46.4%), with an adjusted hazard ratio of 0.28 (P = 0.003). Additionally, the incidence of decompensated cirrhosis was lower in the surgical group (15.6%) vs. the nonsurgical group (30.7%), with an adjusted hazard ratio of 0.20 (P = 0.01).

Source:

Aminian A, et al. (2025, January 27). Nat Med. Long-term liver outcomes after metabolic surgery in compensated cirrhosis due to metabolic dysfunction-associated steatohepatitis. https://pubmed.ncbi.nlm.nih.gov/39870816/