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ForumsMASH / Liver DiseaseFibrosis regression on GLP-1 — need advice Page 2

Fibrosis regression on GLP-1 — need advice

COA_Karl Tue, Mar 24, 2026 at 4:16 AM 12 replies 679 viewsPage 2 of 3
BethLabQueen
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Mar 24, 2026 at 6:17 AM#6
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.

References:
[1] Newsome PN, et al. N Engl J Med. 2021;384(12):1113-1124.
32 2maya_sedona, stefan_berlin, Dr.EM_Chicago and 29 others
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andrew_nyc
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Mar 24, 2026 at 7:04 AM#7

One thing that is still open after Dr.PainCLE’s answer:

Was that from a primary source or from a summary of one?

Last edited: Mar 24, 2026 at 12:04 PM
31 1Dr.NateNeph, PharmD_Rodriguez, julia.endo and 28 others
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Dr.SurgeonPGH
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Mar 24, 2026 at 7:51 AM#8
BethLabQueen said:
NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy.

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

Baseline: "Moderate hepatic steatosis, liver span 17.2cm, echogenic texture consistent with fat infiltration"
Month 8: "Mild steatosis, liver span 15.8cm, improved echogenicity"
Month 14: "Minimal to no steatosis, normal liver span 14.5cm, normal echotexture"

My liver literally shrank and de-fattened. The ultrasound tech said she's seen this pattern increasingly in GLP-1 patients and it's remarkable how consistently the fatty liver resolves.

30 0PharmHunterJen, TomTeleRx, DoseLogDan and 27 others
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COA_Karl
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Mar 24, 2026 at 8:38 AM#9

Closing the loop on my own question.

Update: the thing I was blaming turned out not to be the cause. Leaving the original post as written rather than editing it, so the mistake stays visible for whoever searches this next.

Last edited: Mar 24, 2026 at 9:38 AM
29 24tommy_boulder, hyun_seoul, jim_asheville and 26 others
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RickReta_CO
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Mar 24, 2026 at 12:22 PM#10
Dr.SurgeonPGH said:
Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

True, and it depends on a baseline nobody has stated. Without knowing where someone started, the same number can be an excellent result or a disappointing one.

7 5LindaRN_retired, tommy_boulder, hyun_seoul and 4 others
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