New research suggests diabetes, weight loss drug has potential to improve liver health
By A.J. Hostetler
An ongoing international study led by the Institute’s director suggests that semaglutide, approved to treat weight loss and diabetes, has potential to treat the severe form of fatty liver disease that can otherwise lead to cirrhosis, liver failure, and the need for transplants.
Led by Arun Sanyal, M.D., researchers are exploring the potential of semaglutide to slow or reverse liver damage in people with metabolic dysfunction-associated steatohepatitis, or MASH, offering hope for millions living with this progressive disease.
MASH occurs when fat builds up in the liver, leading to inflammation and scarring. MASH is closely linked to metabolic risk factors like obesity, type 2 diabetes, and high blood pressure, making it a growing global health issue. It’s often called a “silent” disease because many people don’t show outward signs until their liver is already significantly damaged.
The ultimate goal is for semaglutide to reach the right balance of resolving the damage caused by the buildup of fat in the liver (steatohepatitis) while at the same time improving the scarring, or fibrosis. Both are crucial for improving liver health in patients with MASH.
The latest ESSENCE results, presented in San Diego at the annual American Association for the Study of Liver Diseases – The Liver Meeting, recently highlighted the potential of semaglutide not only to improve liver health but also to prevent serious complications down the line.
Semaglutide is a GLP-1 receptor agonist that promotes weight loss, improves blood sugar control, and enhances metabolic health. Sanyal and other researchers are studying several GLP-1 receptor agonists as candidates that might help halt, improve or even reverse the damage caused by MASH.
The new data presented in San Diego at the annual American Association for the Study of Liver Diseases – The Liver Meeting came from the ESSENCE trial, an ongoing global study involving 1,200 participants. The randomized, multicenter phase 3 trial focused on 800 individuals with moderate to advanced liver scarring who were treated for 72 weeks with either 2.4 milligrams weekly injections of semaglutide or a placebo.
“These initial data shared at The Liver Meeting demonstrated that semaglutide 2.4 mg slowed MASH progression and reversed existing liver damage,” said Sanyal, the principal investigator of the large international study. “The ESSENCE data may represent key findings for patients in the treatment of MASH, which is estimated to affect about one in 20 adults in the U.S.”
Of those on semaglutide, 63% of participants experienced a reduction in liver inflammation without worsening scarring, compared to only 34% in the placebo group. More than a third of those on semaglutide showed less liver scarring, compared to 23% in the placebo group. Additionally, about a third of semaglutide users achieved both inflammation reduction and scarring improvement, more than double those in the placebo group.
The drug also helped participants with weight loss, improved liver markers, and boosted overall heart health, with no major differences in serious side effects between the groups.
The ESSENCE is a two-part trial. An overview of the trial’s first part and its design was published in October by the journal Alimentary Pharamcology and Therapuetics. The study’s second phase will follow participants for up to five years to gather data on semaglutide’s impact on long-term liver complications.
Semaglutide is not approved for MASH treatment in the U.S., but manufacturer Novo Nordisk says it plans to seek regulatory approval from the Food and Drug Administration in 2025.