Is it normal for liver enzymes to go UP at first?

jason_sac26 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.

SarahChen_PharmD 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 341 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 15 months: CAP dropped to 244 dB/m (minimal steatosis) and stiffness normalized to 6.199999999999999 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.

jason_sac26 said:

Fatty liver on an incidental scan two years ago and nobody followed it up.

This is my experience too, for whatever a second data point is worth. Posting only so the count is not one.

Clinical perspective, offered as context rather than as advice.

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 6 months on GLP-1 therapy:

FibroScan also improved — liver stiffness from 8.5 kPa to 5.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.