Condition · Moderate evidence

GLP-1s for MASH

Metabolic dysfunction-associated steatohepatitis (MASH, formerly NASH) is a leading non-malignant cause of liver transplant; GLP-1 therapies show promise on liver histology and fibrosis markers, though no GLP-1 is FDA-approved for MASH as of 2026.

Evidence to date

Phase-2 trials of semaglutide in biopsy-confirmed MASH (Newsome et al., NEJM 2021) showed MASH resolution without worsening fibrosis in 59% of treated patients vs 17% on placebo at 72 weeks. Phase-3 data are emerging. Tirzepatide is in active phase-2/3 evaluation for MASH with reported improvements in liver fat fraction.

Status of approvals

Resmetirom (Rezdiffra) was the first FDA-approved MASH-specific drug (March 2024). No GLP-1 receptor agonist is approved for MASH yet, but use is increasingly off-label in patients with concurrent obesity or T2D.