Semaglutide and resmetirom show varying efficacy in treating liver disease

New clinical data and real-world analyses are providing comparative insights into the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH).

An analysis of the STEP UP study, presented at the European Association for the Study of Diabetes (EASD) congress, indicates that semaglutide significantly reduces liver fat in adults with obesity. In a subpopulation of 55 participants, the average liver fat content decreased from 8.8% at baseline to 3.1% after 72 weeks. Approximately 88.5% of participants who started with liver fat levels above 5% successfully reached a level below that threshold.

Separately, a propensity-matched analysis presented at the American College of Gastroenterology (ACG) 2026 meeting compared resmetirom to semaglutide. The study found that patients with MASLD/MASH and hepatic fibrosis who received resmetirom experienced lower rates of major adverse cardiovascular events (MACE) and all-cause mortality over a two-year period compared to those receiving semaglutide. While semaglutide has shown high rates of steatohepatitis resolution, resmetirom—an oral thyroid hormone receptor-β agonist—demonstrated distinct cardiovascular outcomes in this real-world comparison.