COA_Karl 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 Dr.NephBHM_UK — and this may be the naive question:
What would you measure differently if you were starting again?
SleepDoc_PDX 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 10 months on GLP-1 therapy:
| Marker | Baseline | Current | Normal Range |
|---|---|---|---|
| ALT | 55 | 22 | 7-56 U/L |
| AST | 48 | 24 | 10-40 U/L |
| GGT | 75 | 32 | 9-48 U/L |
| ALP | 95 | 82 | 44-147 U/L |
FibroScan also improved — liver stiffness from 9.5 kPa to 5.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.
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Shop Reference StandardsOP back with an update, since a thread like this is useless without one.
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.
DebRD_ATL said:Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).
Agreed, with the usual condition: that holds for the average and this board is a collection of individuals. A population claim and a personal prediction are different things and get quoted interchangeably.