Nearly two out of three individuals with fatty liver disease experienced a reduction in liver fat and inflammation after taking weekly 2.4 mg semaglutide injections for 18 months, according to early results from an ongoing phase 3 clinical trial. These findings were recently published in the New England Journal of Medicine.
Encouraging Results in Reducing Liver Scarring
Significantly, about one in three patients also showed improvement in liver fibrosis—a serious condition where liver scarring impairs normal function. These outcomes suggest semaglutide’s potential to not only manage fat buildup but also reverse structural liver damage in many cases.
Understanding MAFLD: A Growing Concern in India
The disease in question, Metabolic Dysfunction-Associated Steatotic Liver Disease (MAFLD)—previously known as Non-Alcoholic Fatty Liver Disease (NAFLD)—is a chronic condition characterized by excess fat accumulation in the liver. This can lead to inflammation, scarring, and even liver cancer. Experts estimate the prevalence of MAFLD in India to range between 9% and 32%, making it a major public health concern.
Expert Opinion: Phase 3 Trial Strengthens Earlier Evidence
Dr. S.K. Sarin, renowned liver specialist and Vice-Chancellor of the Institute of Liver and Biliary Sciences, emphasized the importance of these findings.
“This study builds on the earlier phase 2 trial. Using the highest dose of semaglutide (2.4 mg), the results show that 62.9% of participants experienced reduced liver fat and inflammation—compared to 34.3% in the placebo group,” Dr. Sarin explained.
Moreover, 36.8% of those on semaglutide saw reduced liver stiffness versus 22.4% on placebo.
Weight Loss: A Likely Contributor to Improvement
As reported by theindianexpress, the study also noted that participants on semaglutide lost around 10% of their body weight, a key factor in improving MAFLD.
“People who lose 7–10% of their body weight generally see improvement in liver fat, and those who lose over 10% often see a reversal of fibrosis—even without medication,” said Dr. Sarin.
However, the study did not isolate weight loss as a variable, making it difficult to determine how much of the liver improvement was due to the drug itself versus the weight loss it induced.
How Semaglutide Works
Semaglutide is a GLP-1 receptor agonist, a class of drugs that mimic gut hormones. It:
- Increases insulin secretion,
- Decreases glucagon (which raises blood sugar),
- Reduces appetite by slowing digestion.
These effects help promote weight loss, which in turn reduces liver fat and inflammation.
Current Treatment Options and Their Challenges
Currently, weight loss remains the cornerstone of MAFLD treatment—whether through lifestyle changes or medication. However, many patients struggle with diet and exercise, which is where medications like semaglutide offer support.
Despite its benefits, semaglutide comes with potential side effects, including:
- Nausea and vomiting,
- Pancreatitis,
- Stomach paralysis,
- Increased risk of thyroid cancer.
In addition to GLP-1 drugs, other treatments include:
- Resmetirom: a thyroid hormone-based drug, priced at approximately $5,400/month,
- FGF21 analogs: target fat tissue metabolism to promote liver health.
The Road Ahead
While semaglutide is not a cure-all, these trial results indicate a major advancement in managing MAFLD, particularly for those unable to lose weight through traditional methods. As more data emerges from ongoing studies, healthcare providers may soon have stronger, more tailored options to combat this growing liver disease epidemic.