Hormonal
Semaglutide (2.4 mg weekly) significantly improves MASH resolution and fibrosis in patients with F2-F3 fibrosis, with benefits extending to significant weight loss and metabolic improvements.
If you have moderate to advanced liver scarring (F2-F3) from metabolic issues, Semaglutide is a new once-weekly injection option. It significantly reduces liver inflammation and scarring, and also promotes weight loss and improves blood sugar and cholesterol. It is generally well-tolerated, though gastrointestinal side effects are common initially.
Semaglutide met both histological endpoints: 62.9% of treated patients achieved MASH resolution compared to 34.2% with placebo (p < 0.001). Additionally, 36.8% of treated patients achieved fibrosis improvement without MASH worsening, compared with 22.4% placebo (p < 0.001)... Patients treated with Semaglutide achieved significantly greater weight loss than those receiving placebo, with a mean reduction of -8.5% (p < 0.001).
Why this rating
Based on Phase 3 randomized, double-blind, placebo-controlled trial (ESSENCE).
Source
AISF practice guidance on pharmacological treatment of metabolic-dysfunction associated steatotic liver disease and steatohepatitis (MASLD/MASH): A 2026 Update
Alessio Aghemo et al. · Digestive and Liver Disease · 2026
DOI 10.1016/j.dld.2026.02.014
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- Resmetirom (80-100 mg daily) improves histological MASH resolution and fibrosis in patients with F2-F3 fibrosis without requiring significant weight loss, while also lowering LDL cholesterol.Strong
- Tirzepatide demonstrates superior weight reduction compared to Semaglutide 2.4 mg and significant MASH resolution in patients with histologically-proven MASH.Good
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