Clinical perspective, offered as context rather than as advice. It helps to ask what evidence would change your mind before you look at any. If nothing would, the discussion is not about evidence, and it is better to say so early than to spend nine posts discovering it.
That is the short version; the long version is somebody else's post.
Dr.EndoEP said:It helps to ask what evidence would change your mind before you look at any.
This matches mine closely enough to be worth saying so out loud. Nothing to add that would improve it.
Dr.EndoEP said:It helps to ask what evidence would change your mind before you look at any.
There is a second half to this that has not been said yet. The liver data is among the strongest non-weight findings in the class. The semaglutide MASH programme reported a large advantage over placebo on MASH resolution, with a substantial minority also achieving fibrosis improvement — and fibrosis is the endpoint that predicts outcomes. Mechanistically it is reduced hepatic lipogenesis, increased fatty-acid oxidation, less hepatic inflammation, and possibly a direct effect on stellate-cell activation.
I would rather be corrected than agreed with, if it comes to it.
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Shop Reference StandardsThe figures, for anyone assembling their own picture. Give anything pharmacological four weeks before you judge it, and give anything measured weekly a four-point rolling average before you call it a trend.
A narrower follow-up, since the general answer is now clear:
Whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is?