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To assess the efficacy of sodium-glucose cotransporter-2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptors agonist (GLP-1RA) therapy on liver steatosis measured by fatty liver index (FLI) and hepatic steatosis index (HSI) at 26 weeks in outpatients with diabetes and obesity.Observational, prospective, multicenter study. Patients with steatosis determined by FLI (values30 rule out and60 indicate steatosis) and HIS (values30 rule out and36 indicate steatosis) who received combination therapy were included. Patients were stratified into three groups according to the sequential order of treatment. We used robust statistical methods.In our final report we included 174 patients (58.6% males), mean age 61.9 (10) years. Baseline body mass index, waist circumference and weight were 36.5 (6.8) kg/mOur results show a beneficial effect of the combination of GLP-1RAs plus SGLT2is on liver steatosis that goes beyond glucose control, and it is related mainly to weight loss, a decline in biomarkers and reductions in abdominal circumference. For many patients, early detection is essential to improving outcomes in NAFLD and could allow us to select the most efficient treatment options.

Aim: To analyze changes on UACR in T2DM patients according to treatment schedule groups (GLP-1RA or SGLT2i). Methods: Observational, prospective, multicenter study. Patients were stratified according to predetermined treatment schedule groups (successively vs.simultaneously). Results: 178 patients (58.6% males, age 61.9+/-10.0 years). Table 1 shows baseline findings by groups. Initial UACR was 19.6+/-52.5 mg/g and initial UACR >30 mg/g (n=68) was 95.1+/-222 mg/g. At 26 weeks significant % change in UACR and UACR>30mg/g was found (4.35+/-30** and 48.8+/105.5**), greater when SGLT2i is added (90.5+/-276.5 *) (Table 2). Discussion: Our results shows that the combination GLP-1ra-SGLT2i reduces UACR, especially if macroalbuminuria is present and is correlated to improvement in either HbA1c, weight and SBP. Disclosure J. Carretero Gomez: None. J. Ena: None. J. Segui-Ripoll: None. F. Carrasco-Sánchez: None. J. Arevalo Lorido: None. M. Suarez Tembra: None. J. Varela: None. R. Gomez-Huelgas: None.

Aim: To analyze changes in Fatty Liver Index (FLI) in obese and T2DM patients under treatment with GLP-1RA - SGLT2i combination. Methods: Observational, prospective, multicenter study. Patients were stratified according to predetermined treatment schedule groups (successively vs. simultaneously). Results: We included 142 patients (59.1% men, mean age 60.8±8.9 years). 76.7% had hypertension and 81.7% dyslipidemia. The BMI was 36.9 ±.7.1 kg/m2, FLI was 97±11, A1C was 8.0% ±1.5%, Triglyceride (Tg) was 158±102 mg/dl, Waist circumference (WC) 120.3 cm and gamma-glutamyl-transferase (GGT) was 43±45 UI/L. At 26 weeks follow-up we found a significant reduction in FLI (-5 points; p Discussion: Nonalcoholic fatty liver disease (NAFLD) is characterized by the accumulation of fat in the absence of other causes of steatosis. FLI is an accurate algorithm which can be used as a surrogate marker of steatosis; it combines measures of Tg, GGT, WC and BMI. GLP-1RA have direct effects on hepatocytes improving liver histology and reducing GGT levels. However, data on SGLT2i over the liver fat are scarce. Our study demonstrated that the combination of GLP-1RAs-SGLT2i reduces liver fat in patients with T2DM being positively correlated with improvement in A1C, BMI, WC and GGT. Disclosure J. Carretero Gómez: None. J. Arevalo Lorido: None. R. Gómez-Huelgas: None. J. Seguí-Ripoll: None. M. Suarez Tembra: None. J. Casas: None. J. Carrasco: None.

Carlos Lahoza,∗, Carlos Esteban Graciab, Leonardo Reinares Garciac, Sergi Bellmunt Montoyad, Angel Brea Hernandoe, Alvaro Fernandez Herederof, Manuel Suarez Tembrag, Marta Botas Velascoh, Carlos Guijarro i, Esther Bravo Ruiz j, Xavier Pintok, Melina Vega de Ceniga l y Guillermo Monux Ducajum, en representacion del grupo de prevencion secundaria de la Sociedad Espanola de Arteriosclerosis y de la seccion de medicina vascular de la Sociedad Espanola de Angiologia y Cirugia Vascular

Statins are safe but have a significant potential for pharmacological interactions. The objective of the study was to evaluate the prevalence of potential interactions throughout the cytochrome P450 isoenzyme 3A4 (CYP3A4) system in a large sample of statin-treated subjects and to determine which factors, from the patient and the physician, were associated with a higher risk of interactions.This is an observational, cross-over, population study that included 7,880 subjects treated with statins. Both data from patients and from the1,681 participating physicians were recorded and analyzed.Fifty-nine percent of the participants were receiving a statin metabolized by the CYP3A4, and 21.5% of all participants received a drug, different from a statin, metabolized by the CYP3A4. There were no differences in the frequency of utilization of statins metabolized or not by the CYP3A4 in relation to the simultaneous prescription of drugs metabolized by the same pathway (22 vs. 21%, respectively). Globally, 12.9% of all participants were at risk of an interaction. These patients were older, received a higher number of drugs and had more comorbidity. Sixty percent of the physicians mentioned that the possibility of an interaction greatly conditioned their selection of a particular statin. Likewise, 56% of them had software that alerted of possible interactions. These aspects, however, did not influence the number of patients at risk of interactions.The proportion of statin-treated patients at risk of interaction is elevated. Physicians do not usually pay attention to this possibility despite having available alert software and therapeutic alternatives.