Semaglutide might be a key for breaking the vicious cycle of metabolically associated fatty liver disease spectrum?

Abstract

Metabolically associated fatty liver disease (MAFLD) is a liver manifestation of metabolic syndrome potentially related to unfavorable hepatic and extrahepatic outcomes and progression to cirrhosis. Up to date, there are no approved pharmacotherapies for the treatment of MAFLD, so management focused on lifestyle interventions to encourage weight loss, and treatment of coexisting conditions is the only available option. Unfortunately, the aforementioned is often not potent enough to offer reversal or slow down hepatic inflammation and fibrosis. Glucagon-like peptide-1 receptor agonists have a favorable effect on glycemic management and weight loss of patients with type 2 diabetes mellitus and recently published data suggest their potential in MAFLD treatment. In addition, some of the agents have proven cardiovascular and renal benefits in dedicated cardiovascular outcome trials, making them an interesting therapeutic option. In this opinion review, we discuss the role of semaglutide in MAFLD.

Keywords: Semaglutide; Non-alcoholic fatty liver disease; Glucagon-like peptide-1 receptor agonists; Metabolically associated fatty liver disease

Core Tip: The pathogenesis of metabolically associated fatty liver disease (MAFLD) is closely interrelated to type 2 diabetes mellitus (T2DM), with insulin resistance and hyperinsulinemia as key characteristics. Glucagon-like peptide-1 receptor agonists have a favorable effect on glycemic management and weight loss in T2DM patients. Semaglutide is an especially interesting agent with favorable metabolic actions in patients sharing T2DM and MAFLD (but also sole MAFLD) phenotype, available in injectable and oral formulation, thus more attractive for a broader spectrum of patients.