SynthesisPeerJ2026
The efficacy of gut microbiota-regulating drugs on metabolic dysfunction-associated steatotic liver disease: a systematic review and network meta-analysis.
Synthesis in PeerJ, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Currently, effective drugs for metabolic dysfunction-associated steatotic liver disease (MASLD) are limited, with treatment primarily focusing on diet and exercise. Recent studies suggest that gut microbiota-regulating drugs may offer therapeutic benefits. Therefore, our aim is to evaluate the efficacy of these medications in MASLD patients. Methods: This systematic review and network meta-analysis involved a search of PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov for randomized controlled trials (RCTs) published from January 1, 2012, to January 28, 2026. The intervention measures encompassed probiotics, prebiotics, synbiotics, antibiotics, postbiotics, and a combination of antibiotics and gut microbiota-regulating drugs. The control group received a placebo or usual care. The risk of bias in the included research was evaluated utilizing the revised Cochrane risk of bias tool for randomised trials. The confidence of evidence will be evaluated through the CINeMA (Confidence in Network Meta-Analysis) web application. Liver enzymes and hepatic steatosis were taken as the primary outcome and were analyzed by random-effects, Bayesian network meta-analyses. A two stage network meta-analysis harnessing the surface under the cumulative ranking curve (SUCRA) was performed for assessing the comparative efficacy of medications classes and particular gut microbiota-regulating drugs. The study was registered on PROSPERO: CRD42024606333. Results: A total of 27 studies comprising 1,511 participants were included in this meta-analysis. Relative to placebo, reductions in alanine aminotransferase (ALT) levels were observed with probiotics (Mean Difference (MD): -7.51, 95% credible intervals (CI) [-12.36 to -2.66]), prebiotics (MD: -13.64, 95% CI [-27.07 to -0.22]) and antibiotics (MD: -24.30, 95% CI [-47.02 to -1.58]). Probiotics (MD: -6.42, 95% CI [-11.91 to -0.92]) and synbiotics (MD: -13.13, 95% CI [-20.82 to -5.45]) were both associated with a reduction in aspartate aminotransferase (AST) levels compared to placebo. Declines in gamma-glutamyl transferase (GGT) levels (MD: -12.40, 95% CI [-23.13 to -1.68]) were observed with synbiotics compared to the placebo. Additionally, synbiotics significantly reduced controlled attenuation parameter (CAP) levels compared with placebo (MD: -45.69, 95% CI [-56.39 to -34.99]). However, no statistically significant differences were observed between probiotics and synbiotics with respect to lipid markers total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), or inflammatory cytokines tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6). Conclusions: Probiotics and synbiotics significantly improve liver enzymes and hepatic steatosis in patients with MASLD.
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