Last updated July 22, 2026
Key finding
HbA1c decreased significantly from baseline.
This study evaluated the combination therapy of Tofogliflozin and Pioglitazone for treating hepatic steatosis in patients with NAFLD and T2DM, showing significant improvements in various metabolic parameters.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Medium-Term (3–12 mo)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study evaluated the combination therapy of Tofogliflozin and Pioglitazone for treating hepatic steatosis in patients with NAFLD and T2DM, showing significant improvements in various metabolic parameters.
This research highlights the potential of combination therapy in managing hepatic steatosis among patients with NAFLD and T2DM, addressing a critical gap in treatment options. Improved metabolic parameters can lead to better overall health outcomes and reduce the risk of complications associated with these conditions.
Limited generalizability due to specific participant characteristics. Short duration of follow-up may not capture long-term effects. Potential for unmeasured confounders affecting outcomes.
Published in
Publication details and source links for this paper.
Masato Y, Takashi K, Yasushi H, et al. Combination Therapy of Tofogliflozin and Pioglitazone for Hepatic Steatosis in Patients with NAFLD and T2DM. Hepatology Communications. 2022;6(9):2273-2285. doi:10.1002/hep4.1993
HbA1c decreased by 0.73% (p=0.001) after combination therapy.
Hepatic steatosis decreased by 5.98% (p=0.0001) following treatment.
ALT levels decreased by 35.7 IU/ml (p=0.0001) after combination therapy.
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Dapagliflozin plus linagliptin combination therapy, Pioglitazone, Tofogliflozin and Adiponectin, Alanine Aminotransferase (ALT), Change in ketone body levels after combination therapy, and 4 more.
This study contributes evidence to
Primary intervention
Dapagliflozin plus linagliptin combination therapy
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
4
Related topics
9
Evidence pairs
709
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Contributes evidence
Evidence topic
Contributes evidence
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Contributes evidence
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Contributes evidence
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Primary evidence
Evidence relationship
Related evidence
Evidence topic
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Core evidence
The primary outcomes reported in this study.
Dapagliflozin plus linagliptin combination therapy → Adiponectin
Dapagliflozin plus linagliptin combination therapy → Adiponectin
Dapagliflozin plus linagliptin combination therapy → Alanine Aminotransferase (ALT)
Dapagliflozin plus linagliptin combination therapy → Alanine Aminotransferase (ALT)
Dapagliflozin plus linagliptin combination therapy → Change in ketone body levels after combination therapy
Dapagliflozin plus linagliptin combination therapy → Change in ketone body levels after combination therapy
Dapagliflozin plus linagliptin combination therapy → HbA1c
Dapagliflozin plus linagliptin combination therapy → HbA1c
Dapagliflozin plus linagliptin combination therapy → HDL cholesterol
Dapagliflozin plus linagliptin combination therapy → HDL cholesterol
Dapagliflozin plus linagliptin combination therapy → Resolution of Hepatic Steatosis
Dapagliflozin plus linagliptin combination therapy → Resolution of Hepatic Steatosis
Dapagliflozin plus linagliptin combination therapy → Triglycerides
Dapagliflozin plus linagliptin combination therapy → Triglycerides
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Thiazolidinediones and HbA1c, Tofogliflozin and HbA1c.
This study contributes to the evidence on the following intervention-outcome relationships.
Medications
Medications
Curated evidence collections and hubs this study is part of.
All studies measuring HbA1c
Measures HbA1c as a key outcome.
All studies on Thiazolidinediones
Contributes to Thiazolidinediones evidence base.
All studies on Tofogliflozin
Contributes to Tofogliflozin evidence base.
All studies measuring Adipokine and Angiogenic Markers
Measures Adipokine and Angiogenic Markers as a key outcome.
All studies on Dapagliflozin plus linagliptin combination therapy
Contributes to Dapagliflozin plus linagliptin combination therapy evidence base.
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4 results
2 results
4 results
2 results
4 results
Generated from the study's connected evidence using Evidence Intelligence™.
Thiazolidinediones appears to improve HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
HbA1c
EvidenceScore™ Strong | EvidenceScore™ 79.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 4 supporting studies with consistent results and a positive effect signal.
Limitations
Tofogliflozin appears to improve HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
HbA1c
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Dapagliflozin plus linagliptin combination therapy appears to improve Adiponectin.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Adiponectin
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Dapagliflozin plus linagliptin combination therapy appears to improve Alanine Aminotransferase (ALT).
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Alanine Aminotransferase (ALT)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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