Popular Weight Loss Medication Cleared to Treat Advanced Liver Disease

Wegovy (semaglutide) injection has been approved by the U.S. Food and Drug Administration to treat metabolic-associated steatohepatitis (MASH) in people with moderate-to-advanced fibrosis (excessive liver scar tissue). Nonalcoholic steatohepatitis, or MASH, is a dangerous liver condition. First licensed in 2017, Wegovy is also approved to treat obesity or overweight and to lower the risk of cardiovascular events, including heart attacks, in people who are at high risk for them. MASH affects 14.9 million individuals in the United States, accounting for around 6% of the population, and its prevalence is rising.

MASH, formerly known as NASH or non-alcoholic steatohepatitis, is a severe kind of fatty liver disease. Typically, it starts as metabolic-associated fatty liver disease (MAFLD), in which the liver gradually accumulates fat as a result of inadequate metabolism.

According to Scott Isaacs, MD, president of the American Association of Clinical Endocrinology and adjunct associate professor at Emory University School of Medicine in Atlanta, Wegovy, which contains the active ingredient semaglutide, helps people lose weight in order to manage MASH.

Semaglutide reduces appetite, cravings, and “food noise” by acting on the brain’s appetite regulatory region, according to Dr. Isaacs. This results in noticeable, long-lasting weight loss. “This weight loss can reverse the inflammation and cellular damage in MASH, improve insulin sensitivity, and reduce liver fat.”

The FDA reported that liver biopsies at 72 weeks in an ongoing clinical trial of 800 MASH patients randomly allocated to receive Wegovy or a placebo showed that the drug was successful in improving liver health.

The FDA reports that overall, 63 percent of Wegovy individuals experienced MASH resolve or no worsening of liver scarring, compared to 34 percent of placebo participants. Furthermore, compared to 22% of those receiving a placebo, 37% of those on Wegovy experienced improvement in liver scarring and no worsening of MASH.

To find out if the reductions in inflammation and scarring observed after 72 weeks result in fewer liver transplants, deaths, or other liver-related health problems, the FDA said the trial will last up to 240 weeks.

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