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Current Drug Development Pipeline for MASLD and MASH: Focusing on Cardiovascular Comorbidities
Veronika A Prikhodko1, Sergey V Okovityi1,2
1Department of Pharmacology and Clinical Pharmacology, Saint Petersburg State Chemical and Pharmaceutical University, 14A Prof. Popov Str., 197022 St. Petersburg, Russia.
Biomedicines
|May 4, 2026
Summary
Metabolic dysfunction-associated steatotic liver disease (MASLD) treatments, including resmetirom and semaglutide, show promise in reducing cardiovascular events and mortality. Incretin mimetics are particularly highlighted for managing co-existing heart conditions in MASLD patients.
Area of Science:
- Hepatology
- Cardiology
- Metabolic Diseases
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) affects a large global population and is linked to cardiometabolic risks.
- MASLD can independently contribute to cardiovascular morbidity and mortality, necessitating integrated treatment approaches.
- Developing treatments that address both liver and cardiovascular outcomes is crucial.
Purpose of the Study:
- To review the current clinical development pipeline for MASLD.
- To identify drug candidates with potential cardiovascular benefits.
- To discuss the mechanistic links and evidence for these benefits.
Main Methods:
- Review of the modern MASLD clinical development pipeline.
- Analysis of preclinical and real-world data for drug candidates.
- Focus on drugs with known or purported cardiovascular benefits.
Main Results:
- Resmetirom and semaglutide significantly reduce major adverse cardiovascular events and mortality in MASH patients.
- Semaglutide showed improvements in heart failure with preserved ejection fraction, suggesting potential for incretin mimetics.
- Other investigational drugs show promise for lipid and glycemic control, but cardiovascular effectiveness is unproven.
Conclusions:
- Integrated treatment strategies are needed for MASLD, addressing hepatic, metabolic, and cardiovascular outcomes.
- Resmetirom and semaglutide demonstrate significant cardiovascular benefits in MASH patients.
- Incretin mimetics represent a promising therapeutic class for patients with concomitant MASLD/MASH and cardiovascular disease.
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