Liver biopsy changes on semaglutide — 6 month update

anna.melb_AU said:

The liver data is among the strongest non-weight findings in the class.

All true, with one condition: that curve is for people who reached the dose on schedule. Anyone who slowed the ladder for tolerability is on a different, flatter curve, and comparing yourself with the published mean will make you feel like a non-responder when you are not.

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

Dr.MetabolicMD said:

Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

Saving this. It is the first explanation that did not require me to already understand it. Sending this to two other people who asked me the same thing last week.

anna.melb_AU said:

The liver data is among the strongest non-weight findings in the class.

I read this differently from anna.melb_AU, on substance rather than tone. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.

The figures, for anyone assembling their own picture. With resmetirom now available for MASH, combination approaches are being explored, so the standard of care in this area is moving faster than most threads assume.

Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source. No action needed from anybody.