Research
Hormonal
Incretin therapies (semaglutide, tirzepatide) achieve MASH resolution and fibrosis improvement primarily through substantial, dose-dependent weight loss.
Semaglutide (2.4 mg weekly) and tirzepatide are weekly injections that reduce liver fat and inflammation by driving significant weight loss. They are highly effective for MASH resolution.
GoodSupportsHIGH confidence
incretins as weight-centric, pleiotropic agents... tirzepatide achieved both endpoints with large, dose-related weight loss.
Why this rating
Supported by Phase 2/3 RCTs (ESSENCE, SYNERGY-NASH).
Source
THR-β Agonists vs Incretin Therapies for Noncirrhotic Metabolic Dysfunction-Associated Steatohepatitis (MASH): A Biopsy-Anchored Systematic Review With Grading of Recommendations Assessment, Development and Evaluation (GRADE) Certainty
Amirah A Alzaki et al. · Cureus · 2026
DOI 10.7759/cureus.106038
systematic_review · n=3796
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- There is no head-to-head evidence to determine which drug class (THR-β vs Incretins) is superior for histological outcomes in MASH.Strong
- Resmetirom (THR-β agonist) improves biopsy-confirmed MASH resolution and fibrosis without causing significant weight loss, acting through a lipid-centric mechanism.Good
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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