Novo Nordisk: Semaglutide (Wegovy) 2.4 mg improved liver markers at week 72 in adults with MASH and BMI <27 kg/m²

Study and population

This post hoc analysis of the phase 3 ESSENCE trial examined a subgroup of 106 adults with metabolic dysfunction‑associated steatohepatitis (MASH) and liver scarring who had BMI <27 kg/m². These patients were drawn from the first 800 randomized participants in the 72‑week interim analysis; ESSENCE is a two‑part trial evaluating once‑weekly semaglutide 2.4 mg versus placebo in adults with MASH and moderate‑to‑advanced fibrosis.

Key week 72 results

At week 72, semaglutide 2.4 mg versus placebo was associated with lower liver enzymes and improved non‑invasive markers: ALT ETR 0.61 (95% CI 0.48–0.79), AST ETR 0.67 (95% CI 0.56–0.80); disease activity FAST ETD −0.13 (95% CI −0.26 to −0.01); fibrosis markers ELF ETD −0.45 (95% CI −0.73 to −0.17) and PRO‑C3 ETR 0.82 (95% CI 0.71–0.95). VCTE‑LSM showed an ETR of 0.88 with a 95% CI of 0.73–1.06 (CI included 1.0).

Context and limitations

Investigators presented the findings at The Liver Meeting® (AASLD) 2026. The analyses are exploratory and post hoc, intended to generate hypotheses and to supplement histologic subgroup results (steatohepatitis resolution and fibrosis improvement); additional work is needed to confirm clinical validity. Authors note these data highlight MASH in people without obesity and do not establish definitive clinical benefit beyond the trial endpoints.