Semaglutide and MASH — liver histology improvement data

SarahChen_PharmD said:

It helps to ask what evidence would change your mind before you look at any.

Adding the part of the answer the thread has not reached. 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.

Worth separating that from liver and MASH, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

Ask again with the specifics and you will get a better answer than this one.

Adding the numbers, since they settle part of this. One practical note: write down what you did and when, before you need it. Reconstructing a timeline from memory three months later is how people end up unable to answer the one question that would have resolved it.

One thing that is still open after SarahChen_PharmD’s answer:

Whether anyone has held at a sub-maximal dose long term and kept the result, or whether the maintenance data only exists at 2.4mg?

PharmacoVig_BOS said:

One practical note: write down what you did and when, before you need it.

Pushing back on PharmacoVig_BOS here. I would resist the confidence. Half of what this board was certain about two years ago has since been quietly dropped, and nobody went back to correct the threads.

PharmacoVig_BOS said:

One practical note: write down what you did and when, before you need it.

Agreed on the substance. I would put less weight on the timescale, because two months of anything is not enough to distinguish a trend from a wobble.