Authors
Maria Mironova, Vlad Ratziu, Mary E Rinella, Meena B Bansal, Mazen Noureddin, Naim Alkhouri, Quentin M Anstee, Philip N Newsome, Jörn M Schattenberg, Arun J Sanyal, Rohit Loomba
Published in
Gut. Sep 11, 2026. Epub Sep 11, 2026.
Abstract
The recent conditional US Food and Drug Administration (FDA) approval of two therapies, resmetirom (Rezdiffra) and semaglutide (Wegovy), marks the first time clinicians have pharmacological therapy for metabolic dysfunction-associated steatohepatitis (MASH) with significant fibrosis (F2-F3) without cirrhosis, a disease that previously had no available pharmacological treatment. The two agents act through complementary mechanisms: resmetirom as a liver-directed thyroid hormone receptor-beta agonist and semaglutide as a glucagon-like peptide-1 receptor agonist (GLP-1 RA) with a broad spectrum of metabolic effects. In this international expert panel review, we consolidate data from phase III trials, FDA labels and emerging clinical experience into a single resource. It covers the entire care pathway: non-invasive test-based diagnosis of MASH with significant fibrosis, treatment selection and initiation, on-treatment monitoring and response assessment. We offer practical recommendations for individualising therapy by patient phenotype, managing patients already receiving GLP-1 RAs and defining response, non-response and criteria for switching or combining agents. The proposed framework is intended to evolve as long-term outcomes data emerge and additional MASH therapies become available.
PMID:
42728029
Bibliographic data and abstract were imported from PubMed on 12 Sep 2026.
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