Cardiovascular events, mortality, and incident type 2 diabetes in patients with metabolic dysfunction-associated steatohepatitis: a claims-based analysis of commercial and Medicare Advantage enrollees.

Background: The objective of this study was to examine the risks of cardiovascular events, incident type 2 diabetes (T2D), and mortality in patients with newly diagnosed metabolic dysfunction-associated steatohepatitis (MASH) compared with those without MASH in a large real-world setting in the US.

Methods: We retrospectively analyzed US claims data from Optum®'s de-identified Clinformatics® Data Mart database from October 2015 to December 2022. Patients with newly diagnosed MASH were matched 1:1 on age, sex, region, and index month-year with patients without MASH, and repeated for a subgroup without baseline diabetes. Risks of clinical outcomes associated with MASH were assessed using Cox proportional hazard models.

Results: The study comprised 24,278 matched pairs in the patients with and without MASH cohorts. Patients with MASH had increased risks for any cardiovascular event (adjusted HR: 1.48 [95% CI = 1.38-1.58]), and all-cause mortality (1.31; 1.20-1.42) compared to those without MASH. For the subgroup without baseline diabetes (10,027 matched pairs), the adjusted HRs were 1.94 (95% CI = 1.68-2.23) for incident T2D and 1.40 (95% CI = 1.20-1.64) for all-cause mortality.

Conclusion: Our findings suggest increased risks of cardiovascular events, incident T2D, and mortality among patients newly diagnosed with MASH compared with patients without MASH.