This review examines the opportunities and unresolved issues around resmetirom and semaglutide, the first approved drug therapies for metabolic-associated steatohepatitis (MASH) with moderate-to-severe liver fibrosis. It reports that both drugs resolve MASH and improve fibrosis in a significant proportion of patients and are generally well tolerated, but it highlights unresolved questions about patient selection, monitoring, treatment duration and equitable access.
Narrative review — Expert review. Population: Patients with metabolic-associated steatohepatitis (MASH) and moderate-to-severe liver fibrosis. Interventions: Resmetirom; Semaglutide.
The review reports that both drugs resolve MASH and improve liver fibrosis in a significant proportion of patients, and that they are generally well tolerated but can cause significant gastrointestinal side effects. Neither drug's approval was based on long-term endpoints, and the authors note that key issues such as patient selection, monitoring, treatment duration, effects on hepatic and systemic outcomes, and equitable access remain unresolved.
For researchers studying semaglutide, this paper positions it as one of the first approved pharmacological therapies for MASH with fibrosis and outlines the clinical challenges around its use, including patient selection and follow-up. It does not establish quantitative efficacy, dosing, comparative effectiveness, or long-term safety outcomes.
Peptide profiles: Semaglutide.
All indexed evidence: Semaglutide trials & papers.
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