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ForumsMASH / Liver DiseaseEfinopegdutide MASH data — July 2024

Efinopegdutide MASH data — July 2024

KarenAZ_mom Thu, May 30, 2024 at 2:14 PM 39 replies 2,830 viewsPage 1 of 8
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KarenAZ_mom
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May 30, 2024 at 2:14 PM#1

ALT was mildly raised at baseline, normalised at month five, and I now have no idea whether anything happened to the fibrosis that actually matters.

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.

If the honest answer is that nobody knows, that is a useful answer and I would rather have it.

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mike.trainer_LA
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May 30, 2024 at 2:50 PM#2
KarenAZ_mom said:
ALT was mildly raised at baseline, normalised at month five, and I now have no idea whether anything happened to the fibrosis that actually matters.

NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy. The Phase 2b data for semaglutide showed 59% NASH resolution (vs 17% placebo) with 43% achieving fibrosis improvement[1].

Mechanism: GLP-1R activation reduces hepatic lipogenesis, increases fatty acid oxidation, reduces hepatic inflammation, and may directly reduce hepatic stellate cell activation (fibrosis pathway).

With resmetirom (thyroid hormone receptor agonist) recently approved for NASH, the field is evolving rapidly. Combination approaches (GLP-1 + resmetirom) are being explored.

References:
[1] Newsome PN, et al. N Engl J Med. 2021;384(12):1113-1124.
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mike_nyc
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May 30, 2024 at 3:26 PM#3
mike.trainer_LA said:
NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy.

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 325 dB/m (moderate steatosis) and stiffness 9.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 11 months: CAP dropped to 228 dB/m (minimal steatosis) and stiffness normalized to 6.1 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.

Last edited: May 30, 2024 at 7:26 PM
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LindaRN_retired
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May 30, 2024 at 4:02 PM#4
KarenAZ_mom said:
ALT was mildly raised at baseline, normalised at month five, and I now have no idea whether anything happened to the fibrosis that actually matters.

This matches mine closely enough to be worth saying so out loud. The detail I would add is minor and it is already implied above.

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BariatricNurseD
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May 30, 2024 at 7:24 PM#5

Adding the clinical framing, because it changes how the question reads.

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 11 months on GLP-1 therapy:

MarkerBaselineCurrentNormal Range
ALT64317-56 U/L
AST572110-40 U/L
GGT94339-48 U/L
ALP1048644-147 U/L

FibroScan also improved — liver stiffness from 10.5 kPa to 6.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.

Last edited: May 31, 2024 at 12:24 AM
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