An interim analysis of a global trial reveals that semaglutide effectively resolves steatohepatitis and reduces liver fibrosis, while also promoting weight loss and enhancing metabolic health for individuals with advanced fatty liver disease. This groundbreaking study, published in The New England Journal of Medicine, highlights the potential of semaglutide as a multi-targeted therapeutic option for metabolic dysfunction–associated steatohepatitis (MASH). With over one billion people affected by fatty liver disease globally, this discovery could significantly impact treatment options for MASH patients.

Promising Efficacy of Semaglutide in Resolving Steatohepatitis

Semaglutide demonstrated remarkable success in addressing key aspects of MASH during the trial. It resolved steatohepatitis without worsening fibrosis in 63% of participants, far exceeding the placebo group's results. Additionally, it reduced liver fibrosis without exacerbating steatohepatitis in 37% of cases. These outcomes indicate that semaglutide can simultaneously target both hepatic and metabolic pathways, offering hope for patients suffering from this progressive condition.

The trial involved 800 adults diagnosed with MASH and moderate-to-advanced liver fibrosis. Participants were randomly assigned to receive either semaglutide or a placebo over an initial 72-week period. By the end of the study, those receiving semaglutide experienced significant improvements in multiple areas. Notably, they achieved a mean weight reduction of 10.5%, compared to just 2% in the placebo group. Furthermore, noninvasive measures like enhanced liver fibrosis scores and liver stiffness showed substantial improvement in favor of semaglutide users. Specifically, 55.8% of these patients saw at least a 0.5-point decrease in their ELF score, contrasting sharply with only 25.5% in the placebo group.

Safety Profile and Broader Implications of Semaglutide Treatment

Besides its efficacy, semaglutide exhibited a manageable safety profile consistent with known effects of glucagon-like peptide-1 receptor agonists. While gastrointestinal side effects were more prevalent among semaglutide recipients, they remained generally tolerable. Serious adverse events occurred equally between both groups, and discontinuation rates due to side effects were minimal. Importantly, no new safety concerns emerged throughout the trial, reinforcing semaglutide's reliability as a long-term treatment option.

Metabolic markers also improved significantly under semaglutide therapy. Levels of glycated hemoglobin, insulin resistance, high-sensitivity C-reactive protein, and lipid parameters all showed favorable changes across diverse subgroups, including individuals with type 2 diabetes mellitus. These findings underscore semaglutide's broad applicability and effectiveness in managing not only MASH but also related conditions such as obesity and type 2 diabetes. As final conclusions on long-term clinical outcomes await the full trial completion, this interim analysis already establishes semaglutide as a transformative advancement in treating advanced fatty liver disease.