The key ingredient in blockbuster weight-loss drugs could help people manage a serious liver condition before it becomes life-threatening, a new trial has found.
The results, published on Wednesday in the New England Journal of Medicine, offer the latest evidence that weight loss drugs could help with a host of health issues beyond type 2 diabetes and obesity, which is what they’re currently approved for in the European Union.
The drug, semaglutide, belongs to a class of medicines called GLP-1 receptor agonists, which work by suppressing people’s appetites. But research suggests that they could also help with issues as wide-ranging as addiction, blood clotting, and dementia.
Now, the new study shows they could be a viable treatment for patients with metabolic dysfunction-associated steatohepatitis (MASH), which occurs when fat builds up in the liver and causes inflammation and scarring.
If left untreated, it can progress to cirrhosis, which is advanced, irreversible liver damage. MASH isn’t linked to alcohol, but it is tied to obesity, type 2 diabetes, and high blood pressure.
‘Hugely exciting’ trial results
The late-stage clinical trial was funded by the drugmaker Novo Nordisk, which sells semaglutide as Ozempic and Wegovy. It included 800 patients with MASH and moderate or advanced liver fibrosis, or the build-up of scar tissue in the liver.
After 72 weeks, 33 per cent of patients who took semaglutide once per week saw improvements on both inflammation and scarring in the liver, compared with about 16 per cent of those who got the placebo or dummy treatment.
Considering inflammation and scarring separately, about 63 per cent of semaglutide-taking patients lowered their inflammation, and 37 per cent saw their scarring improve.
That’s compared with about 34 per cent and 22 per cent, respectively, in the placebo group.
People on semaglutide also lost 10.5 per cent of their body weight, on average.
The study results are “hugely exciting,” said Dr Debbie Shawcross, a professor of hepatology and chronic liver failure at King’s College London in the UK and vice secretary general of the European Association for the Study of the Liver.
But semaglutide might not get all the credit, because patients in both the drug and placebo groups also received lifestyle counselling and recommendations on how to manage their other health conditions.
About half of the study participants had type 2 diabetes, and about three in four were obese.
Shawcross said that because 34 per cent of people in the placebo group lowered their liver inflammation – without losing much weight – it suggests that lifestyle changes could also play a big part in helping people manage MASH.
“This is important as any therapy that is licensed for MASH with moderate to severe fibrosis must be used in conjunction with lifestyle interventions,” Shawcross, who was not involved in the new study, told Euronews Health.
ADVERTISEMENTIn the trial, patients taking semaglutide also experienced some side effects, such as nausea, diarrhoea, constipation, and vomiting. Adverse effects prompted 2.6 per cent of them to drop out of the study.
A potential new treatment for MASH
When Novo Nordisk published the trial’s topline results in November 2024, the company said it would ask EU and US regulators to approve the drug for patients with MASH by mid-2025.
At the time, company executive Dr Martin Holst Lange said the medicine could help fill a “significant unmet need” for patients with MASH.
A Novo Nordisk spokesperson did not respond to a Euronews Health request on Wednesday seeking an update on the timeline.
ADVERTISEMENTNo medicines have yet been approved to treat MASH in the EU, but others have also shown promise in recent years.
The drug resmetirom, for example, helped improve liver scarring in a late-stage trial published last year and has since been green-lit in the US.
It’s still under consideration by EU regulators.
Shawcross said it is too early to tell whether semaglutide could be a “game-changer” for MASH patients, but that it is “certainly a powerful tool in the hepatologist’s armamentarium if it is used in conjunction with lifestyle modification programmes”.
ADVERTISEMENTShe noted that many people who take weight-loss drugs don’t make lifestyle changes that could help boost health outcomes if they wean off the medicines, which is a “significant concern for us all”.
“There are many motivations for patients closely followed-up within trials to make positive adjustments to their lifestyles which may not be seen in the real world,” Shawcross said.
