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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMASH / Liver DiseaseHad a FibroScan and do not understand my results - help — looking for input

Had a FibroScan and do not understand my results - help — looking for input

tane_welly Mon, Jan 20, 2025 at 11:35 PM 40 replies 2,420 viewsPage 1 of 8
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tane_welly
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Jan 20, 2025 at 11:35 PM#1

Read the primary source rather than the write-up and the two do not agree, so here is what is actually in it.

The liver data is among the strongest non-weight findings in the class. The semaglutide MASH programme reported a large advantage over placebo on MASH resolution, with a substantial minority also achieving fibrosis improvement — and fibrosis is the endpoint that predicts outcomes. Mechanistically it is reduced hepatic lipogenesis, increased fatty-acid oxidation, less hepatic inflammation, and possibly a direct effect on stellate-cell activation.

Where I think it is weakest: the comparator does most of the work in how this gets reported, and it is not the comparator most people think they are citing.

What I actually want to know is whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is. Not looking for reassurance. Looking for the part I have got wrong.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
48 18GraceAZ_72, carl_compliance, DanielChem_CHI and 45 others
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kate.chem
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Jan 21, 2025 at 12:26 AM#2
tane_welly said:
The liver data is among the strongest non-weight findings in the class.

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 7 months on GLP-1 therapy:

MarkerBaselineCurrentNormal Range
ALT56237-56 U/L
AST592310-40 U/L
GGT66359-48 U/L
ALP1067344-147 U/L

FibroScan also improved — liver stiffness from 9.5 kPa to 6.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.

Last edited: Jan 21, 2025 at 3:26 AM
47 17VanRx_Mike, steve_okc, dave_SLC and 44 others
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Dr.GutHealth
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Jan 21, 2025 at 1:17 AM#3
tane_welly said:
The liver data is among the strongest non-weight findings in the class.

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.
Last edited: Jan 21, 2025 at 6:17 AM
46 16jennifer_SEA, tyler_CSCS, VanRx_Mike and 43 others
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MASHdoc_SA
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Jan 21, 2025 at 2:08 AM#4
Dr.GutHealth said:
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…

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 325 dB/m (moderate steatosis) and stiffness 9.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 11 months: CAP dropped to 238 dB/m (minimal steatosis) and stiffness normalized to 6.1 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.

45 15LabKate, kate.chem, DataDave and 42 others
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WendyG_ATL
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Jan 21, 2025 at 6:55 AM#5
kate.chem said:
Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).

Mine went the same way, slower.

44 14DebRD_ATL, KristenIndy, MarkLI_maint and 41 others
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