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ForumsMASH / Liver DiseaseHad a FibroScan and do not understand my results - help — need advice

Had a FibroScan and do not understand my results - help — need advice

MikeFit_NJ Mon, Sep 1, 2025 at 8:00 PM 11 replies 1,248 viewsPage 1 of 3
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MikeFit_NJ
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Sep 1, 2025 at 8:00 PM#1

Writing this once so I can stop repeating it across threads. It is about liver and MASH, and it is deliberately narrow — everything I am not confident about is marked as such.

What is actually established

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.

The condition it depends on

ALT falling is not the same as fibrosis improving. Enzymes are a crude proxy; FIB-4 or elastography is what tells you about the thing that matters.

The practical version

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.

What I am not sure about

So the question, as narrowly as I can put it: whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is. Not looking for reassurance. Looking for the part I have got wrong.

— MikeFit_NJ · corrections welcome and will be edited into this post with credit
28 23LeilaHI, marcus_mpls, DeniseRN_TPA and 25 others
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KevinCompounds
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Sep 1, 2025 at 10:16 PM#2
MikeFit_NJ said:
The liver data is among the strongest non-weight findings in the class.

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.

References:
[1] Sanyal AJ, et al. N Engl J Med. 2024.
Last edited: Sep 2, 2025 at 12:16 AM
27 22Dr.RaviCardio, jennifer_SEA, tyler_CSCS and 24 others
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Dr.ObesityLA
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Sep 2, 2025 at 12:32 AM#3
MikeFit_NJ said:
The liver data is among the strongest non-weight findings in the class.

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 329 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 15 months: CAP dropped to 242 dB/m (minimal steatosis) and stiffness normalized to 5 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.

26 21tampaLisa73, KarenAZ_mom, zoe_NC and 23 others
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DebRD_ATL
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Sep 2, 2025 at 2:48 AM#4
Dr.ObesityLA said:
Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 329 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible…

Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Baseline: "Moderate hepatic steatosis, liver span 17.2cm, echogenic texture consistent with fat infiltration"
Month 8: "Mild steatosis, liver span 15.8cm, improved echogenicity"
Month 14: "Minimal to no steatosis, normal liver span 14.5cm, normal echotexture"

My liver literally shrank and de-fattened. The ultrasound tech said she's seen this pattern increasingly in GLP-1 patients and it's remarkable how consistently the fatty liver resolves.

25 20PedsEndoPhilly, SleepDoc_PDX, RegAffairsDC and 22 others
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paige_pharma
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Sep 2, 2025 at 4:23 PM#5
KevinCompounds 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…

Adding a me-too, because a thread of one person's experience is not much use. Nothing to add that would improve it.

24 19lucas_SP_BR, lisa_labSD, adam_van and 21 others
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