Alcohol + MASH + GLP-1 — July 2024

PurityPaulOR said:

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

Pushing back on PurityPaulOR here. The objection nobody has made: this only works if the measurement is doing what we assume it is doing, and that assumption has not been tested here.

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.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

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.

Dr.SportsMedIN said:

The objection nobody has made: this only works if the measurement is doing what we assume it is doing, and that assumption has not been tested here.

Coming at Dr.SportsMedIN’s question from a different direction. Order of operations matters more than any single choice here: establish a baseline, change one thing, wait long enough for it to express itself, then measure again under the same conditions.

A narrower follow-up, since the general answer is now clear:

Whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is?

OP back with an update, since a thread like this is useless without one.

Closing this out. What actually changed my mind was the point about waiting for a trend instead of reading a single measurement, which is embarrassing in hindsight and worth saying anyway.