ByLucy Notarantonio
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A medication already used by millions of people for diabetes and obesity could offer new hope for patients with one of the most serious forms of liver disease, according to new research
Researchersat the University of California San Diego School of Medicine have reported that semaglutide, a GLP-1 receptor agonist widely prescribed for type 2 diabetes and obesity, may help reduce liver scarring in people with advanced metabolic dysfunction-associated steatohepatitis (MASH), a severe form of fatty liver disease
The findings, published in The Lancet Gastroenterology & Hepatology on July 15, highlight a potential treatment option for patients with advanced disease, including those with early-stage cirrhosis
Dr. Mohammad Bakhtiar, a general practitioner who was not involved in the study, told Newsweek: “The results are encouraging, but they are not yet definitive.”
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Semaglutide Improves Liver Scarring
The Phase II clinical trial included around 700 adults with biopsy-confirmed MASH and moderate to advanced liver fibrosis, including some patients with compensated cirrhosis, an early stage of the condition in which the liver is heavily scarred but still functioning
Researchers were primarily investigating whether combining semaglutide with zalfermin, an experimental metabolic therapy, could reverse liver fibrosis more effectively than either treatment alone
While the combination approach did not perform better than placebo, semaglutide alone produced a statistically significant improvement in liver scarring without worsening the inflammation that drives the disease. The benefit was also seen in patients with the most advanced stages of illness
“This is the first clinical trial to demonstrate that semaglutide may improve liver fibrosis in patients with advanced MASH, including those with compensated cirrhosis,” Rohit Loomba, MD, senior author of the study, gastroenterologist and hepatologist at UC San Diego Health and chief of the Division of Gastroenterology and Hepatology at UC San Diego School of Medicine, said in a statement
“The results with semaglutide alone are encouraging and suggest a potential new treatment option for a group of patients who previously had very few.”
Due to the early stage of the research, Bakhtiar cautioned people with MASH against rushing to request semaglutide
He said: “They are at a much earlier stage than the patients included in this trial, and we already know what works for them: losing weight, getting blood sugar under control, cutting back on alcohol and becoming more physically active
“GLP-1 medication should sit alongside those measures, under proper medical supervision, rather than replacing them.”
A Growing Cause of Liver Failure
According to the American Liver Foundation, an estimate nine to 15 million adults have MASH. It has become one of the fastest-growing causes of liver failure and liver transplantation. Many people are living with the disease yet have “no idea” they have it, Bakhtiar noted
The condition develops when fat accumulates in the liver, triggering inflammation and damage. Over time, this can lead to fibrosis, the buildup of scar tissue that progressively impairs liver function. In its most advanced stages, the disease can result in cirrhosis, liver failure and the need for a transplant
Bakhtiar, who works at Medical Express Clinic in London told Newsweek: “It often goes undiagnosed until it is advanced and, even then, is frequently picked up by chance during routine blood tests.”
He advises people with excess abdominal weight, type 2 diabetes, or a family history of liver disease to ask their doctor about a liver check rather than waiting for symptoms, which may never appear
Treatment options for patients whose disease has already progressed to cirrhosis have historically been limited. Many clinical trials have excluded these patients, making effective therapies particularly difficult to identify
The new findings are therefore notable because they suggest semaglutide could benefit a group of patients with significant unmet medical needs
Blood Tests May Reduce Need for Biopsies
Researchers also found that non-invasive blood tests and imaging techniques appeared to reflect treatment-related improvements more clearly than liver biopsies
The discovery could have implications for how patients are monitored in the future. Liver biopsies remain the gold standard for assessing disease progression, but they are invasive and difficult to repeat regularly
If further research confirms the findings, clinicians may be able to rely more heavily on blood tests and imaging to track a patient’s response to treatment over time
More Studies Needed
The authors stressed that larger trials focused specifically on patients with cirrhosis will be necessary to confirm the results
They also noted that other drugs in the same broader class as zalfermin, but designed differently, may still have potential and warrant further investigation
“These findings strengthen the need to continue studying semaglutide and other metabolic therapies in advanced liver disease,” Loomba said
“Our goal is to move the field toward effective, accessible treatments that can slow or even reverse liver damage before patients reach liver failure.”
Reference
Loomba, R., George, J., Castera, L., Francque, S., Lawitz, E., Shoeb, A., Clausen, J.O., Andersen, B., Larsen, A.B. and Gluud, L.L. (2026). Efficacy and safety of zalfermin co-administered with semaglutide in participants with fibrosis and cirrhosis due to metabolic dysfunction-associated steatohepatitis: a phase 2, dose-ranging, double-blind, randomised controlled trial. The Lancet Gastroenterology & Hepatology. [online] doi:10.1016/s2468-1253(26)00123-8
Contact Newsweek editors on this story: Kara Dolman andJames Debens
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