Hormonal
Semaglutide (2.4 mg weekly) induces MASH resolution in patients with stage 2-3 fibrosis, though it does not significantly improve fibrosis itself.
Semaglutide 2.4 mg weekly is highly effective at resolving active liver inflammation (MASH) in patients with moderate fibrosis. However, it does not reverse the scarring (fibrosis) itself. Patients should expect significant weight loss and metabolic improvement, but should not assume their liver scarring will disappear with this drug alone.
At 72 weeks, semaglutide 0.4 mg/daily induced MASH resolution (defined as no more than mild residual inflammatory cells infiltration and no hepatocyte ballooning) in the absence of fibrosis worsening, in 59% of the patients compared to 17% of patients receiving placebo.
Why this rating
Based on a phase 2 RCT (Newsome et al.) with biopsy-proven endpoints, though conflicting results exist in cirrhotic populations.
Source
Metabolic dysfunction-associated steatotic liver disease: An opportunity for collaboration between cardiology and hepatology
Paolo Raggi et al. · Atherosclerosis · 2024
DOI 10.1016/j.atherosclerosis.2024.117523
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