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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMASH / Liver DiseaseHas anyone dealt with fibrosis regression on glp-1?

Has anyone dealt with fibrosis regression on glp-1?

JenMemphis Sat, Apr 26, 2025 at 7:21 PM 46 replies 1,810 viewsPage 1 of 10
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JenMemphis
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Apr 26, 2025 at 7:21 PM#1

ALT was mildly raised at baseline, normalised at month five, and I now have no idea whether anything happened to the fibrosis that actually matters.

So the question, as narrowly as I can put it: whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.

I would rather have one careful answer than five confident ones.

7 2MikeKY_noInsulin, Dr.RaviCardio, jennifer_SEA and 4 others
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TirzTom
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Apr 26, 2025 at 8:25 PM#2
JenMemphis said:
ALT was mildly raised at baseline, normalised at month five, and I now have no idea whether anything happened to the fibrosis that actually matters.

Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Baseline: "Moderate hepatic steatosis, liver span 17.2cm, echogenic texture consistent with fat infiltration"
Month 8: "Mild steatosis, liver span 15.8cm, improved echogenicity"
Month 14: "Minimal to no steatosis, normal liver span 14.5cm, normal echotexture"

My liver literally shrank and de-fattened. The ultrasound tech said she's seen this pattern increasingly in GLP-1 patients and it's remarkable how consistently the fatty liver resolves.

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AttorneyGrant
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Apr 26, 2025 at 9:29 PM#3
TirzTom said:
Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 321 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 13 months: CAP dropped to 234 dB/m (minimal steatosis) and stiffness normalized to 5.7 kPa. Hepatologist says the liver is essentially healing itself as the metabolic stress resolves.

GLP-1 agonists may become first-line NASH therapy. The Phase 3 data on semaglutide for NASH is very promising.

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JakeSmashed95
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Apr 26, 2025 at 10:33 PM#4
JenMemphis said:
ALT was mildly raised at baseline, normalised at month five, and I now have no idea whether anything happened to the fibrosis that actually matters.

This matches mine closely enough to be worth saying so out loud.

Last edited: Apr 27, 2025 at 3:33 AM
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LipidDoc_ATL
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Apr 27, 2025 at 4:38 AM#5

From the other side of the consultation, briefly.

ATTAIN trial (survodutide) context for liver and MASH: survodutide, a GLP-1/glucagon dual agonist, showed -18.7% body weight at 46 weeks in the Phase 3 ATTAIN trial. NASH resolution was achieved in ~60% of patients[1].

This is relevant to liver and MASH because survodutide's glucagon agonism specifically targets hepatic lipid metabolism — making it potentially the best-in-class agent for NASH/MAFLD comorbid with obesity.

References:
[1] Sanyal AJ, et al. N Engl J Med. 2024.
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