MikeFit_NJ said:The liver data is among the strongest non-weight findings in the class.
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.
[1] Newsome PN, et al. N Engl J Med. 2021;384(12):1113-1124.
BiostatsBrad said:NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy.
Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 10 months on GLP-1 therapy:
| Marker | Baseline | Current | Normal Range |
|---|---|---|---|
| ALT | 67 | 24 | 7-56 U/L |
| AST | 50 | 22 | 10-40 U/L |
| GGT | 87 | 38 | 9-48 U/L |
| ALP | 97 | 79 | 44-147 U/L |
FibroScan also improved — liver stiffness from 9.5 kPa to 5.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.
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Shop Reference StandardsOP back with an update, since a thread like this is useless without one.
Closing this out. What actually changed my mind was the point about waiting for a trend instead of reading a single measurement, which is embarrassing in hindsight and worth saying anyway.
julia.endo said:Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).
True, with the qualification that this is a self-selected group. The people for whom it did not work post less, and that shapes everything we think we know.