New research shows that semaglutide, the compound in the weight-loss drug Wegovy, could treat an increasingly common liver disease.
The study, published Wednesday in the New England Journal of Medicine, included 800 adults with a severe form of liver disease known as metabolic dysfunction-associated steatohepatitis, or MASH. People develop MASH after fat builds up in the liver, which can lead to inflammation, cell damage and scarring. The condition, which affects nearly 15 million adults in the United States alone, is one of the most common reasons for liver transplants nationwide. It is closely linked with obesity and Type 2 diabetes, both of which are also on the rise.
Novo Nordisk, the company that makes Ozempic and Wegovy, sponsored the study, as is common with clinical trials. The Phase 3 trial included people with moderate or advanced levels of liver scarring.
After 72 weeks, nearly 63 percent of those who received semaglutide injections and around 34 percent of those on placebo shots saw the fat and inflammation in their livers clear up without any worsening of their liver scarring.
And nearly 37 percent of those who took semaglutide had less scar tissue than they started the trial with, with no worse inflammation or fat buildup. That was compared to around 22 percent in the placebo group.
Inflammation and fat in the liver are the major factors that cause liver scarring in people with MASH, which can then lead to liver failure, said Dr. Vandana Khungar, a hepatologist at Yale New Haven Hospital who was not involved with the study. Patients may need a liver transplant, or can die from the disease.
Novo Nordisk has asked the Food and Drug Administration to approve Wegovy as a treatment for MASH. Eli Lilly, which makes the competitor drugs Mounjaro and Zepbound, has also studied whether the compound in those medications can treat MASH, with promising early results.
There is only one medication currently approved to treat the condition, Rezdiffra, which the F.D.A. cleared last March. Recent research has also shown that bariatric surgery could help treat MASH.
Beyond that, doctors often encourage patients to lose weight, in the hopes of improving liver inflammation and preventing additional scarring. Nearly three quarters of participants in the trial had obesity, and more than half had Type 2 diabetes.
Participants in both the placebo group and the group that took semaglutide trial received nutrition and exercise counseling, which appeared to have an effect. Some people in the placebo group lost weight — 2 percent of their body weight, on average, compared to around 11 percent in the treatment group — and saw improvements in liver health.
Dr. Arun Sanyal, director of the Stravitz-Sanyal Institute for Liver Disease at Virginia Commonwealth University and the lead author on the study, said “there’s no question” that weight loss was a major driver of the improvements among patients on semaglutide. People who took the drug also had lower blood sugar and less insulin resistance, which likely contributed to better liver outcomes. It’s possible the drug has other effects, he said, including that it might reduce inflammation in the liver.
One limitation of the study is that the majority of participants were white, Dr. Khungar said. Only five patients in the entire trial were Black. And since most people in the trial had obesity, it isn’t clear whether the drug will be as effective in patients who do not have excess weight, she added.
Longer-term data will show whether semaglutide can prevent liver transplants or death from liver disease, Dr. Khungar said.
Novo Nordisk is continuing to monitor trial participants to see how their liver disease progresses. The company anticipates new data in 2029.
Nina Agrawal contributed reporting.
