US prevalence
~25% of US adults
Source: AASLD
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Condition
NAFLD / MASLD (Fatty Liver Disease)
Metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD) affects 25-30% of US adults. GLP-1 and GLP-1/GIP agonists show robust reductions in liver fat. No GLP-1 is currently FDA-approved for MASLD/MASH. However, semaglutide 2.4 mg achieved NASH resolution in 59% of patients in a phase 2 trial, and tirzepatide showed similar liver fat reductions in SYNERGY-NASH. Evidence grade: B (phase 2-3 RCTs). Resmetirom (Rezdiffra) is the only FDA-approved MASH drug as of 2024; GLP-1s are used off-label or based on coexisting obesity/T2D indications. Phase 3 ESSENCE trial of semaglutide for MASH read out positively in 2024.
Quick answer
UpdatedNon-alcoholic fatty liver disease (NAFLD) — recently renamed MASLD (metabolic dysfunction-associated steatotic liver disease) — affects ~25% of US adults. It is the most common liver disease, strongly linked to obesity, T2D, and insulin resistance. ~20% of NAFLD patients develop NASH (steatohepatitis) which can progress to cirrhosis. GLP-1 medications (semaglutide, tirzepatide) show evidence of reducing liver fat and inflammation — Wegovy was FDA-fast-tracked for MASH consideration based on Phase 3 data.
- US prevalence: ~25% of adults (~80 million)
- AASLD epidemiologic data
- NASH progression: ~20% of NAFLD progresses to NASH
- Cirrhosis risk in subset
- Semaglutide trial: Significant NASH resolution at 72 weeks
- Phase 2 trial, Newsome et al NEJM 2021
- Tirzepatide trial: SYNERGY-NASH ongoing Phase 3
- Anticipated FDA submission 2025-2026
- First-line therapy: Weight loss (7-10%) + Mediterranean diet
- Resmetirom (FDA-approved 2024) for MASH