PLAINSBORO, N.J. – November 07, 2026 -- Novo Nordisk reported that adults with metabolic dysfunction-associated steatohepatitis (MASH) who started semaglutide 2.4 mg once weekly lost a statistically significant mean 18.9 lb (8.6 kg; about 8%) from baseline versus patients on resmetirom at six months, according to real-world data presented at AASLD The Liver Meeting 2026 in Denver.
PLATINUM-Truveta compares 2,873 semaglutide patients with 2,285 on resmetirom
The retrospective cohort study drew on de-identified electronic medical records from 30 US health systems in the Truveta database, covering June 2021 through March 2026. Semaglutide 2.4 mg was also associated with significantly greater reductions than resmetirom in AST and some cardiometabolic measures. Researchers assessed ALT, AST, body weight, HbA1c, platelets, triglycerides, HDL and LDL at three and six months.
Patients with prior use of either drug, cirrhosis or other chronic liver diseases were excluded, and treatment persistence was required at each time point. The analysis used generalized estimating equations with inverse probability of treatment weighting to reduce confounding.
RHODIUM-2 tracks 2,479 semaglutide initiators against 70,702 untreated MASH patients
The second analysis, drawn from more than 30 US health systems over the same period, found that people initiating semaglutide 2.4 mg had greater one-year reductions in liver enzymes and weight than those who did not. They also had a larger HbA1c decrease. Outcomes were measured at 3, 6 and 12 months.
Patients with cirrhosis or other liver disease causes were excluded, as were those treated with GLP-1 receptor agonists or resmetirom within six months before first treatment.
Observational design limits causal conclusions, Novo says
Both studies were retrospective and observational. Treatment was not randomized, baseline characteristics differed between groups, and results covered only patients with available follow-up measurements who met persistence criteria. Novo cited possible unmeasured confounding, short follow-up because both drugs were recently approved, and potential coding inaccuracies in electronic medical records.
Eric Lawitz of the Texas Liver Institute and University of Texas Health San Antonio said every MASH patient has "different metabolic needs," and that the analysis may help clinicians inform treatment decisions.
Undiagnosed disease burden shapes the commercial opportunity
More than 250 million people live with MASH, and nearly 90% remain undiagnosed, according to figures cited by Novo. Advanced-stage cases are expected to rise over 160% from 2015 to 2030. More than 40% of people with MASH have type 2 diabetes, and more than 8 in 10 also live with obesity.
FDA accelerated approval remains contingent on the ESSENCE phase 3 trial
Semaglutide 2.4 mg holds FDA accelerated approval for adults with MASH and moderate-to-advanced liver fibrosis, excluding cirrhosis, alongside a reduced-calorie diet and increased physical activity. Continued approval may depend on clinical benefit confirmed in a confirmatory trial. Novo is evaluating the drug in the ongoing ESSENCE phase 3 trial in adults with stage F2 or F3 fibrosis.
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