Obesity Drugs Show Promise for Liver Disease
The therapeutic reach of GLP-1 drugs could be expanding significantly. A new study indicates that semaglutide, the active ingredient in drugs like Ozempic, may effectively treat MASH, a severe liver disease. This potential new indication opens up a massive new market for what were once primarily diabetes and obesity treatments.
Metabolic Dysfunction-Associated Steatohepatitis (MASH) affects a significant portion of the population, with an estimated 22 million adults in the U.S. having the condition. The global market for MASH treatments was valued at approximately $7.9 billion in 2024 and is projected to surge to $31.8 billion by 2033. Until recently, the primary management for MASH focused on lifestyle changes, as there were no approved medications. This changed in March 2024 when the FDA approved Rezdiffra (resmetirom) from Madrigal Pharmaceuticals, the first-ever therapy specifically for MASH with moderate to advanced liver scarring. Novo Nordisk's Phase III ESSENCE trial for semaglutide 2.4mg (Wegovy) showed that 62.9% of participants achieved MASH resolution without worsening of fibrosis after 72 weeks, compared to 34.3% for the placebo group. The company is expected to seek regulatory approval in the U.S. and EU. Eli Lilly's tirzepatide (Mounjaro, Zepbound), a dual GIP/GLP-1 agonist, is also a strong contender. In a Phase II study, 73.3% of participants on the highest dose achieved an absence of MASH with no worsening of fibrosis after 52 weeks, versus 13.2% on placebo. The competitive landscape is heating up beyond these GLP-1 giants. Other companies like Akero Therapeutics (efruxifermin) and 89bio (pegozafermin) are developing drugs with different mechanisms of action, such as FGF21 analogs, signaling a wave of innovation for a disease with a high unmet need.
