Metabolic Dysfunction-Associated Steatotic Liver Disease

Women with polycystic ovary syndrome and high androgen levels may have a higher risk for liver disease than those with PCOS and normal androgen levels, according to an analysis of UK Biobank data.

GLP-1 receptor agonist use in diabetes and obesity has soared, and indications are now expanding into liver diseases, specifically metabolic dysfunction-associated steatohepatitis. However, the jury is still out on its benefits.

In a Healio video exclusive, Edward V. Loftus Jr., MD, noted that, despite the boom in glucagon-like peptide-1 agonists for diabetes and weight loss, its role in the treatment of liver disease is still up for debate.

Metabolic dysfunction-associated steatotic liver disease affects more than one-third of the world’s population and is associated with significant clinical and economic burden, as well as impairment of health-related quality of life.

To put it simply, diabetes and steatotic liver disease are joined at the hip. They are part of the same biological process that involves multiple organs, connected by the concept of metabolic flexibility — or lack thereof.

Metabolic dysfunction-associated steatohepatitis is significantly more common in patients with type 2 diabetes, and most patients with MASH — formerly known as NASH — experience metabolic abnormalities, including obesity.

Metabolic dysfunction-associated steatotic liver disease is a public health threat, affecting 30% to 38% of the adult population globally. The prevalence has risen in parallel with epidemics of obesity and type 2 diabetes.

Millions of dollars have been spent trying to find medications that could treat this complex disorder. The focus has been on drugs for more severe disease, as it leads to complications, and early stages have been somewhat ignored.

Although use of glucagon-like peptide-1 agonists for diabetes and weight loss has soared with indications now expanding into liver diseases, specifically metabolic dysfunction-associated steatohepatitis, the jury is still out on its benefit.

Survodutide has an “acceptable safety profile” in patients with metabolic dysfunction-associated steatohepatitis with compensated and decompensated cirrhosis, with no dose reduction needed based on pharmacokinetics, according to data.