VIENNA — In this exclusive video from the International Liver Congress 2019, Harith Rajagopalan, MD, PhD, cofounder and CEO of Fractyl, discusses the use of the Revita duodenal mucosal resurfacing endoscopic technology for patients with concomitant type 2 diabetes and nonalcoholic fatty liver disease or nonalcoholic steatohepatitis.
“Our minimally invasive outpatient endoscopic procedure, which ablates the duodenal mucosa to restore insulin sensitivity, has benefits in patients who have an overlap of both type 2 diabetes and NAFLD or NASH,” Rajagopalan told Healio Gastroenterology and Liver Disease. “We report improvements in blood sugar as well as improvements in liver fat via the MRI-PDFF study.”
The study comprised 24 patients with type 2 diabetes, 17 of whom had liver fat percentage of more than 5% at baseline. After duodenal mucosal resurfacing intervention, mean weight was reduced compared with controls (89.7 vs. 86.6 kg; P < .001).
Researchers also observed improvements in alanine aminotransferase (35.75 vs. 25.35 U/L; P < .001), HbA1c (8.4% vs. 7.4%; P = .001), fasting C-peptide (3.22 vs. 2.66 ng/mL; P = .01), homeostatic model assessment of insulin resistance (5.96 vs. 4.14; P = .01), ferritin (90.8 vs. 69.4 ng/mL; P < .001), and triglyceride-to-HDL ratio (5.44 vs. 3.92 U/L; P = .02).
Patients with more than 5% liver fat at baseline had a marked reduction in absolute liver fat from 19% to 12% (P < .001) and relative liver fat (–35.8%; P < .001) at 12 weeks.
“A single-point outpatient intervention that can offer therapeutic value in both glucose lowering and in reducing liver fat and inflammation would be highly attractive,” Rajagopalan said. “We also see favorable lipid and inflammatory parameters with meaningful reductions in ferritin ... and reductions in triglycerides. Importantly, patients who underwent duodenal mucosal resurfacing also saw an 8% increase in HDL.”
Reference: Aithal G. Abstract PS-112. Presented at: International Liver Congress; April 10-14, 2019; Vienna, Austria.
Disclosure: Rajagopalan is the cofounder and CEO of Fractyl.