Non-Pharmacological and Pharmacological Approaches to Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): An Overview
DOI:
https://doi.org/10.47363/JONE/2025(5)140Keywords:
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), Metabolic Dysfunction-Associated Steatohepatitis (MASH), Drug Treatment, Weight Loss, Obesity, MUO (Metabolically Unhealthy Obese), MHO (Metabolically Healthy Obese), RCT ( Randomised Control Trial)Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) closely associates with obesity and type 2 Diabetes. Lifestyle interventions, aiming at substantial weight loss, are cornerstones of MASLD, treatment by improving the histological outcomes. Originally developed as antidiabetic drugs, Incretin Mimetics and SGLT2 Inhibitors also reduce steatosis and fibrosis. Certain Incretin agonists effectively improve histological features of MASLD. On the other hand, despite moderate weight gain, one PPARγ agonist was found to improve MASLD with certain benefit on fibrosis in the RCT. We here discuss liver-related outcomes, induced by different MASLD treatment options and their association with weight loss. As such, we have compared results from clinical trials on drugs acting via weight loss (Incretin Mimetics, SGLT2 Inhibitors) with those exerting no weight loss (Pioglitazone). Furthermore, other drugs in development, which directly target hepatic lipid metabolism (lipogenesis inhibitors, FGF21 analogs), have also been addressed.
