Liver enzymes trending down on GLP-1 — ALT/AST normalization

sean_dublin said:

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).

Thank you — that is the clearest version of this I have read, and I have read a lot of them. Sending this to two other people who asked me the same thing last week.

Adding the clinical framing, because it changes how the question reads. There is a difference between no evidence and evidence of no effect, and this subject is one where the two get swapped freely in both directions.

julia.endo said:

NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. The objection nobody has made: this only works if the measurement is doing what we assume it is doing, and that assumption has not been tested here.

Adding the numbers, since they settle part of this. The boring version of this is the one that works, and the boring version is: measure a baseline, change one variable, wait, measure again under the same conditions. Nobody wants that answer and it is still the answer.

Happy to go further on any of that.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. No action needed from anybody.