We greatly appreciate the comments 1 by Yuanyuan Li and Xiaoze Wang on our paper “Glucagon-like peptide-1 receptor agonist use in patients with liver cirrhosis and type 2 diabetes”. 2 It looks interesting and practical to compare similarity and difference of disease progress between the Simon’s study 3 [cirrhosis mainly caused by nonalcoholic fatty liver disease (NAFLD)] and ours [cirrhosis mainly caused by hepatitis B or C virus infection]. The authors expressed concerns about the nonsignificant difference in the risk of decompensated cirrhosis and hepatic encephalopathy between glucagon-like peptide-1 receptor agonist (GLP-1 RA) users and nonusers after using competing risk analysis with death as the competing risk in our study. We acknowledge these concerns. However, we believe that the lack of statistical significance may be due to the small number of patients (467) after propensity score matching (PSM), resulting in fewer cases of decompensated cirrhosis and hepatic encephalopathy. Instead of PSM, we used the inverse probability of treatment weighting (IPTW) as a covariate adjusted in the regression models to preserve sample size; then, using death as a competing risk, we performed competing risk-adjusted analyses in risk assessment of decompensated cirrhosis and hepatic encephalopathy between GLP-1 RA users and nonusers.
Date:
2024-05
Relation:
Clinical Gastroenterology and Hepatology. 2024 May;22(5):1143-1144.e1.
