A groundbreaking trial reveals that the primary component of popular weight-loss pharmaceuticals may offer a promising treatment for a severe liver condition before it advances to a life-threatening stage. Published in the esteemed New England Journal of Medicine, these findings suggest that weight loss medications may provide relief for an array of health issues extending beyond type 2 diabetes and obesity, for which they are presently authorized in the European Union. The medication, semaglutide, a GLP-1 receptor agonist, functions by curbing appetite. It is noteworthy that research hints at its beneficial effects on various conditions such as addiction, blood clotting, and dementia.
This latest study reveals its potential as a viable treatment for individuals diagnosed with metabolic dysfunction-associated steatohepatitis (MASH), characterized by fat accumulation in the liver leading to inflammation and scarring. Without intervention, MASH can escalate to cirrhosis, an irreversible form of severe liver damage. Though not alcohol-related, MASH is associated with obesity, type 2 diabetes, and hypertension.
The phase III clinical trial, funded by Novo Nordisk (the manufacturers of semaglutide marketed as Ozempic and Wegovy), involved 800 participants with MASH and varying degrees of liver fibrosis. After 72 weeks, a notable 33% of patients who received semaglutide weekly demonstrated improvements in both inflammation and liver scarring compared to approximately 16% receiving the placebo. When considering inflammation and scarring separately, roughly 63% of patients on semaglutide and 37% witnessed improvements in scarring, contrasted with 34% and 22% in the placebo group, respectively. On average, patients on semaglutide experienced a 10.5% reduction in body weight.
Dr. Debbie Shawcross, a specialist in hepatology and chronic liver diseases at King’s College London and a vice secretary general of the European Association for the Study of the Liver, praised the “hugely exciting” outcomes. However, she pointed out that both the treatment and placebo groups were subjected to lifestyle counseling and recommendations for managing other health conditions, which played a significant role. She emphasized the necessity for any therapy licensed for MASH to be complemented by lifestyle interventions.
During the trial, patients on semaglutide encountered side effects like nausea, diarrhea, constipation, and vomiting, with adverse effects causing 2.6% to withdraw from the study. Upon publishing preliminary findings in November 2024, Novo Nordisk aimed to secure regulatory approval for semaglutide as a treatment for MASH from EU and US regulators by mid-2025. Dr. Martin Holst Lange stated that the drug could address a significant unmet need for MASH patients.
Notably, there is currently no approved medication for MASH in the EU; however, other drugs like resmetirom have shown promise. Resmetirom improved liver scarring in a late-stage trial and was subsequently approved in the US, while its EU approval remains pending.
Dr. Shawcross stated that semaglutide could possibly represent a significant advancement for MASH patients, but only if utilized alongside lifestyle modification programs. She also highlighted the concern that patients discontinue weight loss medications without embracing lifestyle changes that could enhance their health outcomes in real-world scenarios.
Source: https://www.euronews.com/health/2025/05/01/weight-loss-drugs-like-wegovy-could-help-serious-liver-condition-that-has-no-cure-all-trea
