PharmacoVig_BOS said:

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 332 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible…

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.

KevinCompounds 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.

NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy. The Phase 2b data for semaglutide showed 59% NASH resolution (vs 17% placebo) with 43% achieving fibrosis improvement[1].

Mechanism: GLP-1R activation reduces hepatic lipogenesis, increases fatty acid oxidation, reduces hepatic inflammation, and may directly reduce hepatic stellate cell activation (fibrosis pathway).

With resmetirom (thyroid hormone receptor agonist) recently approved for NASH, the field is evolving rapidly. Combination approaches (GLP-1 + resmetirom) are being explored.

Dr.LipidDallas said:

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

There is a second half to this that has not been said yet. The mechanism and the magnitude are separate questions. Agreeing that something happens says nothing about whether it happens enough to act on.

Ask again with the specifics and you will get a better answer than this one.

Following on from MASHdoc_SA — and this may be the naive question:

How long did you give it before you decided it was working?

Reporting back.

For the archive: it took about six weeks rather than the two I expected, and the difference between those two numbers was the whole of my problem.