Novo Nordisk: Wegovy normalised liver fat in 88.5% of obese adults in STEP UP subanalysis

Results

In a post hoc pooled analysis presented at EASD 2026, mean liver fat measured by MRI‑PDFF declined from 8.8% at baseline to 3.1% at week 72 in participants treated with semaglutide (pooled 7.2 mg and 2.4 mg). Of the 26 participants who entered with liver fat >5%, 23 (88.5%) reached <5% by week 72.

Population and methods

The MRI‑PDFF subanalysis evaluated 55 adults with excess liver fat drawn from a pooled STEP UP programme of 1,919 participants (STEP UP and STEP UP T2D). Across the pooled population 1,312 received semaglutide 7.2 mg, 304 received 2.4 mg and 303 received placebo. At baseline >94% were classified high risk for fatty liver by the Fatty Liver Index and <1% met criteria for advanced fibrosis by FIB‑4. The liver analysis was post hoc and exploratory, not a pre‑specified primary or secondary endpoint.

Regulatory status and related trials

Semaglutide 2.4 mg (Wegovy) is approved for treatment of MASH in the US, Canada, the UK, China and other markets; semaglutide 7.2 mg is not being investigated for MASH. The ongoing phase 3 ESSENCE trial (n=1,197 randomized 2:1) evaluated 2.4 mg over a planned 240 weeks; part 1 (first 800 biopsies) showed superior fibrosis improvement with no worsening of steatohepatitis versus placebo, and part 2 results are expected in 2029.

Context and implications

Authors note semaglutide reduced liver fat and was associated with improved liver health in adults with obesity, suggesting potential to address early liver disease before progression to fibrosis or cirrhosis. The finding derives from a small MRI‑measured subpopulation within a broader pooled, exploratory analysis.