Semaglutide, the favored weight reduction and diabetes drug, now has the inexperienced gentle to deal with average to extreme metabolic dysfunction-associated steatohepatitis (MASH) . In case you have the situation and are contemplating your remedy choices, chances are you’ll be questioning whether or not this GLP-1 receptor agonist is the appropriate selection for you. Obtainable medical trial information exhibits that semaglutide may be extremely useful for many individuals with MASH. “It’s not solely thought-about secure for these functions, but additionally probably to enhance well being considerably,” says Jessica Cutler, MD , a weight reduction surgeon with the Maryland Bariatric Middle at Mercy Medical Middle in Baltimore. With that mentioned, it’s not essentially the very best match for everybody with MASH or associated liver circumstances.
Semaglutide’s FDA Approval to Deal with MASH Semaglutide for MASH In August 2025, semaglutide obtained an accelerated approval from the U.S. Meals and Drug Administration (FDA) as a first-line remedy possibility for adults with average to extreme MASH. This choice was primarily based on constructive information rising from an ongoing section 3 medical trial, with full approval anticipated to return as soon as the trial is full and the FDA opinions the extra information.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b11927f8-a581-4dff-8956-d3097f514495 The FDA determined that semaglutide ought to obtain accelerated approval for MASH after early outcomes have been so constructive. After 72 weeks, 63 p.c of sufferers receiving semaglutide resolved their MASH and didn’t expertise worse liver scarring or fibrosis, in contrast with 34 p.c of these taking a placebo. Moreover, 37 p.c of sufferers receiving semaglutide improved their liver fibrosis with out their MASH worsening, in contrast with 22 p.c of these taking a placebo.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b11927f8-a581-4dff-8956-d3097f514495 The trial is deliberate to final a complete of 240 weeks, at which level the FDA will look to see whether or not sufferers’ enhancements in liver irritation and scarring noticed after 72 weeks resulted in fewer deaths, liver transplants, and different liver-related well being occasions.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b11927f8-a581-4dff-8956-d3097f514495 Semaglutide improves MASH by addressing two of its underlying causes: extra physique fats and excessive blood sugar . Each result in extra fats accumulation and irritation within the liver, which might result in scarring or fibrosis over time.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bb7ad7f6-4ffa-4ea8-ae16-bb9f8945d51f “By inducing weight reduction and enhancing metabolic well being, semaglutide can lower toxicity from fats accumulation and liver cell injury, permitting the liver to heal and obtain fibrosis regression,” says Naim Alkhouri, MD , hematologist and chief medical officer at Summit Medical Analysis in Phoenix.
Folks With Diabetes Folks With Diabetes Semaglutide is bought below two model names: Wegovy (for weight reduction) and Ozempic (for diabetes). Solely Wegovy is formally accepted for MASH. The medical trial exploring the usage of semaglutide as a remedy for MASH is testing a weekly 2.4 milligram (mg) dose, the utmost Wegovy dose, which is barely increased than the utmost weekly 2 mg dose that’s accepted for Ozempic to deal with diabetes.e60dc2a1-f33c-4a05-9b50-8e3e8e597629660ccc11-e05e-4195-9abb-7b83f691adea Those that have MASH and diabetes and are already taking semaglutide for the latter could also be questioning whether or not the remedy can successfully deal with their MASH as nicely. The reply isn’t but clear as a result of slight distinction in these doses. “Sufferers already on semaglutide for diabetes who need to deal with MASH ought to discuss to their supplier to see if dose escalation is correct for them,” says A. Sidney Barritt IV, MD , director of hepatology at UNC College of Drugs in Chapel Hill, North Carolina.
Folks With out Weight problems Folks With out Weight problems Not everybody with MASH has weight problems. Typically individuals with danger elements like excessive ldl cholesterol or hypertension can develop MASH regardless that their physique mass index (BMI) is taken into account wholesome.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b34ce1ca-f81f-401e-badc-a4d99cc93b9c In the event you’re in that camp, semaglutide will not be as efficient at treating your MASH as those that have weight problems, the information counsel.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ec7d02cf-82b7-47bc-816e-9ca115fd3fbc “[Because] the semaglutide profit is usually oblique by management of weight and diabetes, sufferers with out these comorbidities might not obtain the identical advantages,” says Dr. Barritt. As an alternative, it could be price asking your physician about different remedy choices like resmetirom , which helps enhance MASH with out weight reduction.e60dc2a1-f33c-4a05-9b50-8e3e8e59762919f76c89-25b3-4811-9f8b-5b6ebcf3a375
Older Adults Older Adults Semaglutide is accepted to deal with adults of all ages with average to extreme MASH, however in case you’re over 60 years outdated, there are a couple of issues of which to remember. Fast weight reduction from a GLP-1 places older adults at increased danger for muscle loss, which can result in frailty and accidents that make it tougher to carry out each day actions independently.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294df1a613-6029-4145-b8b3-575b9e046cf6 Older age may make you extra susceptible to experiencing GLP-1-related unwanted effects like nausea, constipation, and dehydration.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c3d2e99e-413c-4f13-b86a-5cdcc4783a70 And in case you’re taking further medicines, which turns into extra frequent with age, it’s essential to be certain none of these medicines work together with semaglutide. “With cautious monitoring, semaglutide can nonetheless be thought-about an efficient and secure instrument for older adults with MASH,” says Yasika Garcia, MD , an endocrinologist with Medical Workplaces of Manhattan in New York Metropolis. Focus on the advantages and downsides together with your physician to find out whether or not semaglutide is the appropriate remedy possibility for you.
Youngsters and Teenagers Youngsters and Teenagers MASH could also be surprisingly frequent amongst youngsters and youths.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290ddcdea0-23a2-4932-ba0a-84454e4bd004 Whereas semaglutide is accepted to deal with weight problems in youngsters over 12 years outdated, it’s not at present accepted to deal with MASH in these below 18. In case your baby has MASH, discuss with their pediatrician about different methods to enhance their liver well being, resembling dietary modifications.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290fe9b24c-e3ed-48d3-8bc0-99b7cf51c6dc
Can Semaglutide Deal with ‘Fatty Liver’? MASLD Metabolic dysfunction-associated liver illness (MASLD) , generally known as “fatty liver,” is a milder type of MASH. With MASLD, the liver reveals some extra fats buildup. With MASH, the fats buildup progresses to the purpose the place it causes liver irritation and scarring.e60dc2a1-f33c-4a05-9b50-8e3e8e59762969af36ac-4255-4cce-b543-d358379f0b25 Presently, semaglutide is just accepted to deal with MASH, not MASLD.e60dc2a1-f33c-4a05-9b50-8e3e8e597629424ee913-8f8e-41bc-a33c-e01aab035166 Nevertheless, weight reduction is a cornerstone of MASLD remedy.e60dc2a1-f33c-4a05-9b50-8e3e8e59762969af36ac-4255-4cce-b543-d358379f0b25 So if in case you have MASLD and also you’re obese or have weight problems, your physician might advocate utilizing semaglutide to succeed in a more healthy weight, which may enhance the well being of your liver.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290ef46657-c3ce-446c-802a-c145232b9c8c
Can Semaglutide Deal with Extreme Liver Illness? Extreme Liver Illness Over time, liver scarring from MASH can result in extreme issues like cirrhosis (superior liver scarring) or liver failure.e60dc2a1-f33c-4a05-9b50-8e3e8e59762913f2a08a-7588-4310-b06e-fd353d35fe55 It will possibly additionally improve one’s danger for liver most cancers . Semaglutide doesn’t look like an efficient remedy for these superior issues and isn’t at present really useful as such.e60dc2a1-f33c-4a05-9b50-8e3e8e59762948f126a3-1a77-4618-a966-8b0c1240afdae60dc2a1-f33c-4a05-9b50-8e3e8e597629bab3b441-ade0-4015-9c72-05fb9dcb7509 It’s additionally unclear whether or not the remedy is secure for individuals with cirrhosis. Although it’s not but understood why, some analysis means that the speedy weight reduction attributable to semaglutide may probably worsen liver scarring.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ac7b2d03-b560-42df-9c4b-0d733c124349
Warnings and Contraindications Warnings Semaglutide is an efficient remedy for MASH, however it’s not applicable for everybody. You shouldn’t take semaglutide if in case you have:e60dc2a1-f33c-4a05-9b50-8e3e8e5976295021d812-69f4-4215-9953-7e28a34fc6c3 A private or household historical past of medullary thyroid most cancers Gastroparesis A number of endocrine neoplasia kind 2 Type 1 diabetes People who find themselves pregnant or breastfeeding also needs to keep away from taking semaglutide.e60dc2a1-f33c-4a05-9b50-8e3e8e597629410be2b8-bcf8-4e4e-ac60-82afc23409ca
The Takeaway The FDA has granted accelerated approval for GLP-1 receptor agonist drug semaglutide as a first-line remedy for adults with average to extreme MASH. Semaglutide works by addressing underlying causes of MASH — specifically extra physique fats and excessive blood sugar — resulting in weight reduction and improved metabolic well being that permit the liver to heal. Whereas typically thought-about secure, semaglutide could also be much less efficient for sufferers with MASH who don’t even have weight problems or diabetes, poses particular dangers for older adults (like muscle loss and unwanted effects), and isn’t accepted for youngsters or teenagers or for these navigating extreme issues like cirrhosis. Contraindications for taking semaglutide embody a private or household historical past of medullary thyroid most cancers, gastroparesis, kind 1 diabetes, and being pregnant or breastfeeding.
Sources We Belief Cleveland Clinic: 8 Life-style Adjustments to Assist Handle MASH U.S. Meals and Drug Administration: FDA Approves Therapy for Severe Liver Illness Often known as ‘MASH’ Harvard Well being Publishing: Diabetes and Weight problems Drug Reveals Promise for Fatty Liver Illness American Affiliation for the Research of Liver Ailments: Why Are GLP-1 Agonists Being Used to Deal with Sufferers With Nonalcoholic Fatty Liver Illness? American Faculty of Gastroenterology: Semaglutide for the Therapy of Metabolic Dysfunction-Related Steatohepatitis
