Hormonal
GLP-1 receptor agonists improve hepatic steatosis and MASH resolution primarily through weight loss and direct inhibition of hepatic de novo lipogenesis.
GLP-1 agonists like semaglutide and liraglutide are effective treatments for MASH, achieving resolution in a significant portion of patients. They work by reducing liver fat through both weight loss and direct metabolic effects. Expect potential gastrointestinal side effects, which are usually manageable.
The primary mechanisms by which GLP-1 receptor agonists improve hepatic steatosis are linked to the reduction in food intake and body weight... GLP-1 also has tissue-specific actions that ameliorate the pathways by which caloric intake and insulin resistance promote the development of MASLD... inhibition of de novo lipogenesis—a major contributor to hepatic triglyceride accumulation—via downregulation of involved genes
Why this rating
Supported by phase 2 trials (LEAN, Semaglutide) with histological endpoints.
Source
Review Article: <scp>GLP</scp>‐1 Receptor Agonists and Glucagon/<scp>GIP</scp>/<scp>GLP</scp>‐1 Receptor Dual or Triple Agonists—Mechanism of Action and Emerging Therapeutic Landscape in <scp>MASLD</scp>
Maryam Zafer et al. · Alimentary Pharmacology & Therapeutics · 2025
DOI 10.1111/apt.70196
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