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Incretin-based Agents and Metabolic Dysfunction-associated Steatotic Liver Disease
Emir Muzurović1,2, Martin Haluzik3,4, Ludek Horváth3,4
1Department of Internal Medicine, Endocrinology Section, Clinical Centre of Montenegro, Podgorica, Montenegro.
Current Pharmaceutical Design
|July 11, 2025
Summary
Incretin-based treatments show promise for metabolic dysfunction-associated steatotic liver disease (MASLD), particularly in patients with obesity and type 2 diabetes mellitus (T2DM). While effective for liver fat reduction, their impact on steatohepatitis and fibrosis requires further investigation.
Area of Science:
- Hepatology
- Endocrinology
- Pharmacology
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease globally, linked to obesity and type 2 diabetes mellitus (T2DM).
- Limited treatment options exist for advanced hepatic dysfunction, with resmetirom being a recent approval for metabolic dysfunction-associated steatohepatitis (MASH).
- Incretin-based receptor agonists are emerging as potential therapeutic agents for MASLD.
Purpose of the Study:
- To review the rationale and potential mechanisms of incretin-based treatments for MASLD/MASH.
- To discuss the current evidence regarding the efficacy of incretin-based agents in improving liver fat, steatohepatitis, and fibrosis.
- To explore the role of these agents in managing the MASLD continuum, especially in patients with metabolic comorbidities.
Main Methods:
- Review of existing literature and clinical trial data on incretin-based treatments for MASLD.
- Analysis of pathophysiological mechanisms underlying MASLD and the proposed actions of incretin mimetics.
- Discussion of evidence from liver-biopsy-powered trials and their implications.
Main Results:
- Incretin-based agents demonstrate significant effects on weight loss and reduction of liver fat content in MASLD patients.
- Evidence for improvement in steatohepatitis and fibrosis is currently limited but growing.
- These treatments may improve metabolic abnormalities and mitigate early-stage MASLD progression, particularly in those with obesity and T2DM.
Conclusions:
- Incretin-based treatments offer a promising avenue for managing MASLD, especially when combined with lifestyle modifications.
- Further research and clinical trials are needed to establish their efficacy in improving liver histology and to gain regulatory approval for MASLD.
- These agents are considered a component of a broader treatment strategy for the MASLD/MASH/fibrosis/cirrhosis continuum.
Keywords:
Metabolic-dysfunction associated steatotic liver diseaseincretin-based agentsmetabolic dysfunction/associated steatohepatitispathophysiology.semaglutidesurvodutidetirzepatideMore Related Videos
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