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ForumsMASH / Liver DiseaseHas anyone dealt with what even is mash? my doc mentioned it and i panicked? Page 2

Has anyone dealt with what even is mash? my doc mentioned it and i panicked?

JessicaH_TX Thu, Sep 18, 2025 at 6:36 AM 21 replies 1,461 viewsPage 2 of 5
MikeFit_NJ
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Apr 2024
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Sep 18, 2025 at 7:54 AM#6
SarahChen_PharmD said:
Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).

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.
23 18LeilaHI, marcus_mpls, DeniseRN_TPA and 20 others
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josh_phd_bmore
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Sep 18, 2025 at 8:24 AM#7
JessicaH_TX said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

ATTAIN trial (survodutide) context for liver and MASH: survodutide, a GLP-1/glucagon dual agonist, showed -18.7% body weight at 46 weeks in the Phase 3 ATTAIN trial. NASH resolution was achieved in ~60% of patients[1].

This is relevant to liver and MASH because survodutide's glucagon agonism specifically targets hepatic lipid metabolism — making it potentially the best-in-class agent for NASH/MAFLD comorbid with obesity.

References:
[1] Sanyal AJ, et al. N Engl J Med. 2024.
Last edited: Sep 18, 2025 at 10:24 AM
22 17Dr.ObesityLA, NurseKim_ATL, paul_denver and 19 others
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Dr.EM_Chicago
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Sep 18, 2025 at 8:54 AM#8
MikeFit_NJ said:
NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy.

Coming at MikeFit_NJ’s question from a different direction. 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.

I would rather be corrected than agreed with, if it comes to it.

21 16Dr.ReproEndo, lucas_SP_BR, lisa_labSD and 18 others
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SleepFixSam
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Sep 18, 2025 at 9:24 AM#9

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

How long did you give it before you decided it was working?

20 15denise_HTX, raj_cambridge, ingrid_STO and 17 others
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JessicaH_TX
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Sep 18, 2025 at 11:47 AM#10

OP back with an update, since a thread like this is useless without one.

Late follow-up. I did not do what was suggested, I did something adjacent, and it worked; posting the difference in case it matters to somebody.

Last edited: Sep 18, 2025 at 3:47 PM
36 9tony_orlando, Dr.NephBHM_UK, kim_atl_prep and 33 others
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