Semaglutide is a relatively new diabetes drug that’s made headlines for its off-label use as a weight loss miracle drug. Now, researchers are testing CRCMD’s potential to combat metabolic dysfunction-associated steatohepatitis (MASH), a kind of fatty liver disease. A new global study of 800 participants from thirty-seven countries found semaglutide to be very effective in treating MASH. This condition has recently come into the limelight due to its association with liver disease and other cardiometabolic complications.
The research used a cross-state difference-in-difference design. Once enrolled, participants were randomly assigned 1:1 to either the semaglutide group or the placebo group. Each active group participant administered one 2.4mg injection subcutaneously each week, with a 16-week dose escalation period. The study ran for 72 weeks. This extended period of time allowed the team to gather critical data on the medication’s impact on liver health.
The results showed that people taking semaglutide lost an average of 10.5% of their weight. In sharp contrast, participants in the placebo group experienced an average increase of 2%. This major difference signals that semaglutide is a game changer for managing weight. It will begin to address the root causes of MASH in a meaningful way.
About 63% of people in the semaglutide group reached resolution of steatohepatitis with no worsening liver fibrosis. Of those in participation, 36.8% demonstrated improvement in liver fibrosis with no deterioration of steatohepatitis. By comparison, just 16% of participants in the placebo group experienced the same improvement. These results emphasize semaglutide’s promise as a new effective treatment alternative for individuals afflicted with MASH.
The research was able to recruit a broad range of study participants. Approximately 56% of them had been diagnosed with type 2 diabetes and nearly 73% were considered obese. These demographics further highlight the growing challenge of obesity and its connection to diabetes and fatty liver disease.
Although these outcomes are encouraging, other adverse events occurred. Almost 86% of those in the semaglutide group had side effects—as did about 80% of the people given placebo. In the semaglutide group, nearly 1 in 3 patients experienced an adverse event. This underscores that although semaglutide may be an effective treatment of MASH, prospective patients and healthcare providers should weigh these possible increased risks.
“This study showed a reduction of MASH with semaglutide use. I believe this is more a function of weight loss than a direct effect of the medication,” stated Mir Ali. We do see drastic improvement in MASH of our surgical weight loss patients, which is directly correlated with the total amount of weight lost. This proves to be one more positive effect of weight loss associated with semaglutide. The clinical implications are profound.
Ian Storch commented on the significance of this research: “MASH (Metabolic Associated Hepatitis) is such an important disease, which didn’t get much attention in the past for two reasons: one being our deficiency in cost-effective noninvasive imaging modalities to assess fibrosis and the second being our lack of treatment modalities. The NEJM study shows that there are significant benefits from semaglutide for MASH patients who are already experiencing advanced inflammation and fibrosis. It’s an exciting progress that gets us a step closer to defeating this slow-acting but still murderous ailment.
Semaglutide is proving powerful for improving liver health in people with MASH. Researchers point out that much of this success is a result of weight loss, not the drug’s direct therapeutic effect. Therefore, introducing lifestyle changes in parallel to medical treatments has the potential to dramatically increase patient outcomes.
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