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ForumsMASH / Liver DiseaseMASH prevalence in GLP-1 users — 6 month update

MASH prevalence in GLP-1 users — 6 month update

CryptoCarl Tue, Sep 24, 2024 at 4:37 PM 12 replies 1,822 viewsPage 1 of 3
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CryptoCarl
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Sep 24, 2024 at 4:37 PM#1

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.

The question I want answered is whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.

Not looking for reassurance. Looking for the part I have got wrong.

5 0CryptoCarl, MariaRD, AussieAnna and 2 others
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PurityPaulOR
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Sep 24, 2024 at 4:47 PM#2
CryptoCarl 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.

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 24, 2024 at 7:47 PM
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fiona_glasgow
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Sep 24, 2024 at 4:57 PM#3
PurityPaulOR said:
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…

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 315 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 13 months: CAP dropped to 238 dB/m (minimal steatosis) and stiffness normalized to 5.1 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.

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maria_elpaso
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Sep 24, 2024 at 5:07 PM#4
CryptoCarl 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.

Same experience, arrived at from the opposite direction.

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GenomicsKate
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Sep 24, 2024 at 5:57 PM#5

From the other side of the consultation, briefly.

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.

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