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ForumsMASH / Liver DiseaseMy liver enzyme journey — ALT from 98 to 19 on semaglutide Page 3

My liver enzyme journey — ALT from 98 to 19 on semaglutide

DerekSJ_a1c Wed, May 27, 2026 at 9:10 AM 29 replies 552 viewsPage 3 of 6
Dr.RenalNash
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May 27, 2026 at 6:07 PM#11
Dr.EndoIndy said:
The liver data is among the strongest non-weight findings in the class.

That holds for the injectable. The oral formulation has different absorption behaviour and the dose numbers are not interchangeable, which is worth saying out loud because people quote them as if they were.

Last edited: May 27, 2026 at 11:07 PM
15 13wei_SG, cory_ATX, lori_vegas and 12 others
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DoseLogDan
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May 27, 2026 at 11:25 PM#12
MASHdoc_SA said:
The dose-response is real but shallow at the top.

Saving this. It is the first explanation that did not require me to already understand it. Sending this to two other people who asked me the same thing last week.

Last edited: May 28, 2026 at 12:25 AM
16 14Dr.AddMedPHL, newstart_MO, mia_MS2 and 13 others
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JakeSmashed95
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May 28, 2026 at 4:42 AM#13
Dr.EndoIndy said:
The liver data is among the strongest non-weight findings in the class.

I read this differently from Dr.EndoIndy, on substance rather than tone. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.

Last edited: May 28, 2026 at 9:42 AM
17 15alex_tucson, kevin_tulsa, Dr.PainCLE and 14 others
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dave_SLC
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May 28, 2026 at 9:59 AM#14

Adding the numbers, since they settle part of this. With resmetirom now available for MASH, combination approaches are being explored, so the standard of care in this area is moving faster than most threads assume.

18 16FranDenver, Dr.BariatricHTX, LindaRN_retired and 15 others
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Admin
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May 28, 2026 at 3:16 PM#15

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Carry on.

19 17PeptideSynthNJ, Dr.KarenChen, Dr.NateNeph and 16 others
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