Novo Nordisk's Wegovy, containing semaglutide, has demonstrated significant efficacy in a Phase 3 clinical trial for metabolic dysfunction-associated steatohepatitis (MASH), a severe form of fatty liver disease. The trial results, announced by Novo Nordisk, indicate that Wegovy met its primary endpoints, showing improvement in both liver fibrosis and MASH resolution. This outcome sets the stage for potential regulatory filings in the U.S. and Europe, potentially expanding the drug's label to include this prevalent condition.
MASH is characterized by the accumulation of liver fat, leading to impaired liver function and, in advanced stages, the need for liver transplantation. It affects over 250 million people globally. Semaglutide, the active ingredient in Wegovy, is a GLP-1 receptor agonist initially approved for type 2 diabetes (marketed as Ozempic). It works by binding to the GLP-1 receptor, triggering metabolic effects that can aid in weight management and improve liver health.
The Phase 3 trial involved 1,200 participants with MASH and moderate-to-advanced liver fibrosis. Patients were administered once-weekly injections of Wegovy in addition to standard care. After 72 weeks, 37% of the Wegovy group experienced improvement in liver fibrosis without any worsening of MASH, compared to 22.5% in the placebo group. Furthermore, 62.9% of patients in the Wegovy group achieved MASH resolution without worsening of liver fibrosis, while only 34.1% in the placebo group reached this endpoint. Novo Nordisk reported that these results were statistically significant, and the safety and tolerability profile of Wegovy in this trial was consistent with previous studies.
The trial is structured in two parts. Part 1, now complete, assessed the drug's impact on liver fibrosis and MASH resolution over 72 weeks. Part 2 is ongoing and will evaluate Wegovy's ability to reduce the risk of liver-related clinical events over a 240-week period, with data expected in 2029. Despite the long-term data still pending, Novo Nordisk anticipates submitting applications for approval in MASH to both the U.S. FDA and the European Medicines Agency (EMA) in the first half of the coming year.
Analysts are cautiously optimistic about Wegovy's potential in MASH. Leerink Partners analyst Thomas Smith noted that the data aligns with their best-case scenario, showing statistically significant improvement in fibrosis. However, Smith also suggested that GLP-1 receptor agonists like semaglutide are not a "silver bullet" for MASH patients with advanced fibrosis and that combination therapies will likely become the standard of care. William Blair analyst Andy Hsieh drew comparisons between Wegovy's fibrosis improvement and that of Madrigal Pharmaceuticals' Rezdiffra, the first FDA-approved MASH treatment. Hsieh noted that the placebo-adjusted improvement in fibrosis with no worsening of disease was 12% for Rezdiffra and 14% for Wegovy.
Other companies, including Eli Lilly and Boehringer Ingelheim, have also presented promising clinical trial results for their MASH therapies. The consensus within the investment community is that GLP-1 receptor agonists will likely play a significant role in the treatment landscape for MASH.
