Semaglutide: Beyond Diabetes Management and Weight Loss
Diabetes-linked liver disease: Potential effectiveness of weight loss medication explored
The versatile medication Semaglutide, a member of the GLP-1 receptor agonists family, has exploded in popularity with brands like Rybelsus, Ozempic, and Wegovy receiving FDA approval for managing diabetes and promoting weight loss. Yet, the intriguing potential benefits of semaglutide don't stop there.
Recent research hints at the possibility of semaglutide improving liver health in individuals battling metabolic dysfunction-associated steatohepatitis (MASH), a severe form of fatty liver disease. A recent study published in The New England Journal of Medicine casts light on semaglutide's stellar performance in this domain.
Semaglutide vs. MASH: Promising Results
In the aforementioned study, 534 participants received semaglutide, while 266 received a placebo. Over the course of 72 weeks, individuals in the semaglutide group witnessed noteworthy improvements in liver status.
- Steatohepatitis Resolution: Roughly 63% of those in the semaglutide group displayed resolved steatohepatitis, a condition where there's no worsening in liver fibrosis. In stark contrast, only 34.3% of participants in the placebo group experienced the same healthful outcome.
- Improved Fibrosis: 36.8% of participants receiving semaglutide observed reductions in liver fibrosis without any worsening of steatohepatitis, compared to 22.4% in the placebo group.
Other salient findings revealed that around 33% of the semaglutide group experienced both steatohepatitis resolution and decreased fibrosis, while this figure was only 16% in the placebo group.
Beyond the Liver: Weight Loss, Pain, and Inflammation
The benefits of semaglutide didn't end at the liver. The medication group also enjoyed an average weight loss of 10.5% compared to just 2% in the placebo group. Although it didn't reach statistical significance, the semaglutide group also notably experienced pain reductions.
In addition, the semaglutide group demonstrated superior results in non-invasive testing and exhibited greater decreases in systemic inflammation and cholesterol levels, as well as superior insulin sensitivity.
Side Effects: A Mild Concern
Despite its numerous upsides, semaglutide wasn't without its drawbacks. About 86% of participants in the semaglutide group reported adverse events, compared to 80% in the placebo group. Notably, the semaglutide group experienced more gastrointestinal events, like nausea and constipation, than the placebo group.
Limitations and Future Research
While the results of this study show promise for using semaglutide to improve liver outcomes, it does have some limitations. The research lacked a significant number of Black participants and lean individuals, making it difficult to extrapolate the findings' implications for these groups.
Additionally, some information about clinical outcomes was withheld due to study integrity concerns, and there was some missing data. Nonetheless, researchers maintain that semaglutide effectively addressed problems associated with metabolic dysfunction that cause liver disorders.
A Potential Liver Disease Treatment in the Making?
With its ability to reverse liver damage and address metabolic dysfunctions linked to steatohepatitis, semaglutide shows promise as a potential new therapy for MASH and fatty liver diseases. Future research will help clarify its safety profile, long-term efficacy, and expand its indications.
Mir Ali, MD, a board-certified general surgeon, bariatric surgeon, and medical director of the MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, speculates that:
"This study showed a reduction of MASH with semaglutide use; however, because the greatest contributor to MASH is obesity, I believe this is more a function of weight loss than a direct effect of the medication. We see significant improvement in MASH in our surgical weight loss patients, and it seems to be directly related to the amount of weight lost."
Ian Storch, DO, an osteopathic physician specializing in gastroenterology and internal medicine, echoes this sentiment:
"MASH is an important disease which didn't get much attention in the past for two reasons, one being our deficiency in cost-effective noninvasive imaging modalities to assess fibrosis and the second being our lack of treatment modalities. The study in the NEJM showing possible benefits of semaglutide in MASH patients with advanced inflammation and fibrosis is another exciting advance in our efforts to conquer this indolent, yet deadly disease."
- Semaglutide's popularity continues to grow, with FDA approvals for managing diabetes and promoting weight loss for brands like Rybelsus, Ozempic, and Wegovy.
- Research suggests that semaglutide may improve liver health in individuals with metabolic dysfunction-associated steatohepatitis (MASH), a severe form of fatty liver disease.
- In a study published in The New England Journal of Medicine, 534 participants received semaglutide, while 266 received a placebo.
- Over 72 weeks, those in the semaglutide group displayed improved liver status, with nearly 63% resolving steatohepatitis.
- In the placebo group, only 34.3% experienced the same healthful outcome of resolved steatohepatitis.
- Semaglutide benefited 36.8% of participants who observed reductions in liver fibrosis, compared to 22.4% in the placebo group.
- Around 33% of the semaglutide group experienced both steatohepatitis resolution and decreased fibrosis, while this figure was only 16% in the placebo group.
- The benefits of semaglutide extend beyond the liver, resulting in an average weight loss of 10.5% for the medication group compared to just 2% in the placebo group.
- Although not statistically significant, the semaglutide group also experienced notable pain reductions.
- Non-invasive testing demonstrated superior results for the semaglutide group, showing greater decreases in systemic inflammation and cholesterol levels, as well as superior insulin sensitivity.
- Roughly 86% of participants in the semaglutide group reported adverse events, compared to 80% in the placebo group.
- Semaglutide users experienced more gastrointestinal events, such as nausea and constipation, than the placebo group.
- The research lacked a significant number of Black participants and lean individuals, making it difficult to draw conclusions for these groups.
- Some clinical outcome information was withheld due to study integrity concerns, and there was missing data.
- Despite its limitations, semaglutide addressed problems associated with metabolic dysfunction that cause liver disorders.
- Semaglutide shows potential as a new therapy for MASH and fatty liver diseases due to its ability to reverse liver damage and address metabolic dysfunctions linked to steatohepatitis.
- Future research will clarify semaglutide's safety profile, long-term efficacy, and expand its indications.
- Mir Ali, MD, highlights that weight loss is likely the primary factor contributing to improvements in MASH with semaglutide use.
- Ian Storch, DO, emphasizes the importance of semaglutide as a potential treatment for MASH, given its ability to address fibrosis and inflammation in advanced cases.
- The breakthrough of semaglutide in managing MASH may lead to improved health and wellness for an estimated 9% of the global population suffering from chronic-kidney-disease.
- Health-and-wellness practitioners may advocate for the use of semaglutide as a complementary treatment option for obesity, chronic-diseases, and type-2-diabetes.
- As with any medication, proper medical-conditions management and finances must be taken into account when considering semaglutide therapies-and-treatments.
- By managing weight with semaglutide, individuals can improve their cardiovascular-health, reduce the risk of respiratory-conditions, and potentially lessen the burden of chronic-kidney-disease, cáncer, and other chronic-diseases.
