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Open Access 26-03-2025 | Metabolic Dysfunction-Associated Steatohepatitis | Review Article

The promise of incretin-based pharmacotherapies for metabolic dysfunction-associated fatty liver disease

Authors: Harendran Elangovan, Jenny Elizabeth Gunton, Ming Hua Zheng, Jian-Gao Fan, George Boon Bee Goh, Henning Gronbaek, Jacob George

Published in: Hepatology International | Issue 2/2025

Abstract

Background

The presence of excess liver fat secondary to metabolic dysregulation represents the end-organ manifestation of a systemic disease that can progress to steatohepatitis, cirrhosis and its feared complications of clinical decompensation and hepatocellular cancer. Since metabolic dysfunction-associated fatty liver disease (MAFLD) is highly prevalent globally, there is a pressing need to augment lifestyle interventions with pharmacotherapies to ameliorate disease burden and reduce adverse liver-related events.

Purpose

This review summarises current evidence for the utility of incretin mimetics in the MAFLD/MASH arena.

Methods

A literature review that encompassed multiple database searches to inform the evidence base for incretin drugs in MAFLD/MASH.

Results

Incretin mimetics demonstrate multifarious benefits across the metabolic diseases spectrum with mounting evidence for their role in remitting steatohepatitis and liver fibrosis. Weight loss and insulin sensitisation contribute, but additional mechanisms may also be engaged. Gastrointestinal adverse effects are common but for most, can be managed while preserving the hepatic and cardiometabolic benefits.

Conclusion

The literature reveals benefits from incretin-based therapies for MASH, but data on whether they improve long-term hepatic outcomes are awaited to support their future incorporation into routine clinical care.

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Title: The promise of incretin-based pharmacotherapies for metabolic dysfunction-associated fatty liver disease
Authors: Harendran Elangovan
Jenny Elizabeth Gunton
Ming Hua Zheng
Jian-Gao Fan
George Boon Bee Goh
Henning Gronbaek
Jacob George
Publication date: 26-03-2025
Publisher: Springer India
Keywords: Metabolic Dysfunction-Associated Steatohepatitis
Incretin Mimetics
Semaglutide
Tirzepatide
Metabolic Dysfunction-Associated Steatotic Liver Disease
Obesity
Incretin Mimetics
Published in: Hepatology International / Issue 2/2025
Print ISSN: 1936-0533
Electronic ISSN: 1936-0541
DOI: https://doi.org/10.1007/s12072-025-10795-6

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Please log in to get access to this content

Should we treat all patients with chronic hepatitis B?

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Burden, trends, and predictions of liver cancer in China, Japan, and South Korea: analysis based on the Global Burden of Disease Study 2021

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