Alcohol + MASH + GLP-1 — July 2024

Short answer first, then the reasoning. 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.

PurityPaulOR said:

The liver data is among the strongest non-weight findings in the class.

Agreed, and ALT falling is not the same as fibrosis improving. Enzymes are a crude proxy; FIB-4 or elastography is what tells you about the thing that matters.

carlos_SATX said:

Alcohol simply stopped appealing, which I did not expect and which has been more socially complicated than the weight loss.

Same pattern here, and in the same order. Posting only so the count is not one.

From the other side of the consultation, briefly. The version of this that has an answer is narrower than the version being asked. Narrow it and it becomes tractable; leave it broad and the thread will produce nine confident and incompatible replies.