Semaglutide: Weight loss, fatty liver gone

In Germany, an estimated 30 percent of adults suffer from metabolically associated fatty liver disease (MASH), which is associated with liver inflammation and can progress to liver fibrosis with scarring and impaired liver function. The disease is closely linked to metabolic risk factors such as obesity or type 2 diabetes.

There are currently no approved medications for MASH in Germany. In the US, the drug resmetirom was approved for the treatment of MASH in 2024. It is a selective THR-β agonist that promotes the breakdown of triglycerides and the β-oxidation of fatty acids. Rezdiffra™ from Madrigal Pharmaceuticals is indicated in combination with diet and exercise for adult MASH patients with moderate to advanced liver fibrosis.

The GLP-1 receptor agonist semaglutide, used to treat diabetes and obesity, could potentially become another treatment option. In the Phase III "ESSENCE" study, it reduced the symptoms of fatty liver disease in more than 60 percent of patients and the severity of fibrosis in more than one-third of patients. All patients had MASH plus stage 2 or 3 liver fibrosis.

An interim analysis of the study , conducted by researchers led by Professor Dr. Arun J. Sanyal of the Virginia Commonwealth University School of Medicine in Richmond and funded by Wegovy® manufacturer Novo Nordisk, was recently published in the New England Journal of Medicine. A total of 1,197 patients are participating in the ongoing study, and this publication evaluates the results of 800 patients after 72 weeks.

534 of them received 2.4 mg semaglutide subcutaneously once weekly, and 266 received a placebo. More than half of the patients had type 2 diabetes, and approximately three-quarters were obese.