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ForumsMASH / Liver DiseaseDoctor said my fatty liver is GONE - I literally cried — what worked for you? Page 2

Doctor said my fatty liver is GONE - I literally cried — what worked for you?

dan_philly Thu, May 16, 2024 at 11:02 PM 14 replies 2,155 viewsPage 2 of 3
COA_Karl
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Jan 2024
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May 17, 2024 at 1:25 AM#6
Dr.SleepRoch said:
Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 325 dB/m (moderate steatosis) and stiffness 9.8 kPa (possible…

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.
38 8matt_MKE, Dr.ReproEndo, lucas_SP_BR and 35 others
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hank_denver
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Sep 2024
Denver, CO
May 17, 2024 at 2:20 AM#7
dan_philly said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 8 months on GLP-1 therapy:

MarkerBaselineCurrentNormal Range
ALT58307-56 U/L
AST562010-40 U/L
GGT73369-48 U/L
ALP1038044-147 U/L

FibroScan also improved — liver stiffness from 10.5 kPa to 5.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.

37 7raj_cambridge, ingrid_STO, pete_nash and 34 others
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Dr.RaviCardio
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May 17, 2024 at 3:15 AM#8
COA_Karl said:
NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy.

Coming at COA_Karl’s question from a different direction. The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either. Those three things can all be true at once, and most arguments here are two people holding different parts of that.

36 6mark_tokyo, hans_munich, jason_sac26 and 33 others
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MounjBrad
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Oct 2024
Kentucky
May 17, 2024 at 4:10 AM#9

Following on from LondonLisa — and this may be the naive question:

What would you measure differently if you were starting again?

Last edited: May 17, 2024 at 9:10 AM
35 5pam_columbus, nick_SD_fit, ben_calgary and 32 others
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dan_philly
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Jul 2024
Philadelphia, PA
May 17, 2024 at 8:34 AM#10

Closing the loop on my own question.

Reporting back with a partial result, because a partial result is still better than silence. Two of the three things suggested helped; I cannot separate them and I am not going to pretend otherwise.

41 14EndoResFellow, PharmacoVig_BOS, SurmountFan_IN and 38 others
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