Can Obesity Drug Help Treat Liver Disease? New Study Says Yes

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A popular obesity medication could be a game-changer for treating and preventing and treating a common form of liver disease.

Marketed as Wegovy and known scientifically as semaglutide 2.4 mg, new data from a major, international trial suggests the drug, part of the GLP-1 receptor agonist class, helped reduce liver inflammation and scarring in people with MASH more than a placebo did. It also led to significant weight loss, which can support liver health.

“The results from this landmark study across 37 countries provide strong evidence that semaglutide can help patients with MASH by not only improving liver health, but also addressing the underlying metabolic issues that contribute to the disease,” said Arun Sanyal, M.D., Ph.D., who is the lead author on the new research and is also a professor of medicine at the Virginia Commonwealth University School of Medicine, in a press release.

MASH stands for Metabolic dysfunction-associated steatohepatitis—a liver disease caused by too much fat building up in the liver, which can lead to swelling (inflammation) and damage to liver cells. Over time, the liver can develop scars, a condition called fibrosis. MASH often happens in people who are overweight, have type 2 diabetes, or high cholesterol. If it’s not treated, it can lead to serious liver problems. But with the right care and treatment, MASH can be managed.

Resmetirom, which is sold under the brand name Rezdiffra, is currently the only treatment approved by the FDA for MASH, a type of liver disease that doesn’t involve cirrhosis. But other treatments are being tested, including semaglutide.

A large study, called the ESSENCE trial, is testing semaglutide to see how well it works for MASH. This study is happening in 37 countries and includes 253 research centers. It involves adults with liver damage (fibrosis stage 2 or 3) and MASH confirmed by biopsy.

In the study, patients were split into two groups. Two out of every three people received semaglutide once a week as a shot under the skin. The others got a placebo (a shot with no active medicine). The treatment lasted for about 4.5 years (240 weeks). The semaglutide dose started low and increased every four weeks until it reached 2.4 mg by week 16.

Researchers recently looked at the first part of the study, focusing on the first 800 patients after 72 weeks.

They wanted to examine two specific effects of treatment:

• If semaglutide could clear up the liver inflammation (steatohepatitis) without making the scarring (fibrosis) worse.
• If semaglutide could reduce liver scarring without making the inflammation worse.

The results showed:

• About 63% of patients taking semaglutide had a resolution of liver inflammation, compared to 34% in the placebo group.
• About 37% of semaglutide patients had less liver scarring, versus 22% in the placebo group.
• About 33% had both improvements, compared to 16% with placebo.

People taking semaglutide also lost more weight: about 10.5% of their body weight, compared to 2% in the placebo group. Pain levels improved slightly more in the semaglutide group, but the difference was not large enough to be considered significant by the study’s standards.

As for side effects, about 86% of people on semaglutide had some kind of side effect, compared to 80% in the placebo group. The most common were stomach issues like nausea, diarrhea, constipation, and vomiting. Serious side effects were similar in both groups (around 13%).

“While these results must be treated with caution, the analysis shows semaglutide can be an effective tool to treat this advanced liver disease,” said study member Philip Newsome, Ph.D., Director of the Roger Williams Institute of Liver Studies at King’s College London, in a press release.