Metabolic dysfunction–associated steatohepatitis (MASH) is a major contributor to liver disease, and reducing hepatic fat is critical for improving patient outcomes. A systematic review and network meta-analysis evaluated the efficacy of various pharmacological treatments in reducing liver fat in MASH patients, as measured by MRI proton-density-fat fraction (MRI-PDFF). The analysis included 39 randomized controlled trials (RCTs) with a total of 3,311 participants. The primary outcome was the absolute change in MRI-PDFF, while the secondary outcome was a ≥30% reduction in MRI-PDFF. Results showed that, at 24 weeks, aldafermin, pegozafermin, and pioglitazone were the most effective in reducing hepatic fat. Efinopegdutide, semaglutide + firsocostat, and pegbelfermin were the most effective at achieving a ≥30% decline in MRI-PDFF.

These findings offer valuable insights into the relative effectiveness of treatments for MASH and could guide the design of future clinical trials. The results also highlight the potential for combination therapies to optimize fat reduction in patients with MASH, aiding in better treatment planning and personalized therapy options.

Reference: Koh B, Xiao J, Ng CH, et al. Comparative efficacy of pharmacologic therapies for MASH in reducing liver fat content: Systematic review and network meta-analysis. Hepatology. 2024 Jul 19. doi: 10.1097/HEP.0000000000001028. Epub ahead of print. PMID: 39028914.