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ForumsMASH / Liver DiseaseLiver biopsy changes on semaglutide — looking for input Page 3

Liver biopsy changes on semaglutide — looking for input

Dr.GutHealth Sat, Oct 19, 2024 at 8:18 AM 29 replies 2,184 viewsPage 3 of 6
AmyNC_wife
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Oct 23, 2024 at 5:06 AM#11
Dr.ObesityLA said:
The mechanism that matters here is not stomach emptying, it is central.

This is exactly what I could not find anywhere else.

30 3JessicaM_2024, TomFromTexas, mike.trainer_LA and 27 others
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pete_nash
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Oct 23, 2024 at 7:54 PM#12

Clinical perspective, offered as context rather than as advice.

Dr.GutHealth said:
...but the FDA says semaglutide...

Interesting point. I want to add some regulatory nuance: the FDA labeling reflects the specific clinical trial data submitted for approval. Real-world clinical practice often extends beyond the FDA label based on emerging evidence and clinical judgment.

Example: semaglutide was first approved for diabetes (Ozempic), then obesity (Wegovy). The molecule didn't change — our understanding of its applications expanded. Similarly, semaglutide may evolve as more data accumulates.

Last edited: Oct 24, 2024 at 1:54 AM
31 4Dr.Martinez, mike_mod, SarahChen_PharmD and 28 others
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mike_nyc
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Oct 24, 2024 at 10:42 AM#13
Dr.KarenChen said:
Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

I will push back on the "any working dose is fine" framing. The maintenance evidence sits overwhelmingly at the top studied dose, and the extension data shows regain tracking dose reduction rather than tracking stopping. Holding low is reasonable; pretending it is evidentially equivalent is not.

Last edited: Oct 24, 2024 at 2:42 PM
32 5Dr.EM_Chicago, pete_RVA, CarlaRPh_TPA and 29 others
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NicoleRaleigh
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Oct 25, 2024 at 1:30 AM#14

Adding the numbers, since they settle part of this. 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.

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mike_mod
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Oct 25, 2024 at 4:19 PM#15

Moderator note: two posts asking for a source have been merged into one. Please search the thread before asking again. No action needed from anybody.

34 7PurityPaulOR, MaxMetOK, MounjBrad and 31 others
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