bbq_ray_KC said:The liver data is among the strongest non-weight findings in the class.
NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy. The Phase 2b data for semaglutide showed 59% NASH resolution (vs 17% placebo) with 43% achieving fibrosis improvement[1].
Mechanism: GLP-1R activation reduces hepatic lipogenesis, increases fatty acid oxidation, reduces hepatic inflammation, and may directly reduce hepatic stellate cell activation (fibrosis pathway).
With resmetirom (thyroid hormone receptor agonist) recently approved for NASH, the field is evolving rapidly. Combination approaches (GLP-1 + resmetirom) are being explored.
[1] Newsome PN, et al. N Engl J Med. 2021;384(12):1113-1124.
Following on from PharmacoVig_BOS — and this may be the naive question:
Did your prescriber agree with that reading, and if not what was their objection?
DanielChem_CHI said:NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy.
Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 6 months on GLP-1 therapy:
| Marker | Baseline | Current | Normal Range |
|---|---|---|---|
| ALT | 55 | 22 | 7-56 U/L |
| AST | 58 | 26 | 10-40 U/L |
| GGT | 65 | 34 | 9-48 U/L |
| ALP | 105 | 72 | 44-147 U/L |
FibroScan also improved — liver stiffness from 8.5 kPa to 5.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.
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Shop Reference StandardsClosing the loop on my own question.
Following up because I said I would. I changed one thing, left everything else alone, and waited the full interval before looking. It resolved, and I cannot prove which half of that did it.
TrialTracker_MD said:Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).
True, with the qualification that this is a self-selected group. The people for whom it did not work post less, and that shapes everything we think we know.
If somebody has the primary source to hand I would rather cite it than paraphrase it.