MASH resolution without worsening fibrosis — 6 month update

Dr.AddMedPHL said:

Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

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:

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.

patPC_UT said:

ALT was mildly raised at baseline, normalised at month five, and I now have no idea whether anything happened to the fibrosis that actually matters.

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 336 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 10 months: CAP dropped to 229 dB/m (minimal steatosis) and stiffness normalized to 5.7 kPa. Hepatologist says the liver is essentially healing itself as the metabolic stress resolves.

GLP-1 agonists may become first-line NASH therapy. The Phase 3 data on semaglutide for NASH is very promising.

pete_manc_UK said:

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

There is a second half to this that has not been said yet. It is worth asking what the claim would look like if it were false. If nothing would look different, it is not a claim about the world and no amount of discussion will settle it.

A narrower follow-up, since the general answer is now clear:

What did you change at the same time, and can you separate the two now?

Closing the loop on my own question.

Update, and it is the boring outcome: nothing was wrong. The measurement I was reading had moved less than its own week-to-week variation, which somebody said upthread and I did not believe.