Randomised clinical trial: Semaglutide versus placebo reduced liver steatosis but not liver stiffness in subjects with non-alcoholic fatty liver disease assessed by magnetic resonance imaging
Journal article, 2021

Background: Glucagon-like peptide-1 receptor agonists may be a treatment option in patients with non-alcoholic fatty liver disease (NAFLD). Aims: To investigate the effects of semaglutide on liver stiffness and liver fat in subjects with NAFLD using non-invasive magnetic resonance imaging (MRI) methods. Methods: This randomised, double-blind, placebo-controlled trial enrolled subjects with liver stiffness 2.50-4.63 kPa by magnetic resonance elastography (MRE) and liver steatosis ≥10% by MRI proton density fat fraction (MRI-PDFF). The primary endpoint was change from baseline to week 48 in liver stiffness assessed by MRE. Results: Sixty-seven subjects were randomised to once-daily subcutaneous semaglutide 0.4 mg (n = 34) or placebo (n = 33). Change from baseline in liver stiffness was not significantly different between semaglutide and placebo at week 48 (estimated treatment ratio 0.96 (95% CI 0.89, 1.03; P = 0.2798); significant differences in liver stiffness were not observed at weeks 24 or 72. Reductions in liver steatosis were significantly greater with semaglutide (estimated treatment ratios: 0.70 [0.59, 0.84], P = 0.0002; 0.47 [0.36, 0.60], P < 0.0001; and 0.50 [0.39, 0.66], P < 0.0001) and more subjects achieved a ≥ 30% reduction in liver fat content with semaglutide at weeks 24, 48 and 72, (all P < 0.001). Decreases in liver enzymes, body weight and HbA1c were also observed with semaglutide. Conclusions: The change in liver stiffness in subjects with NAFLD was not significantly different between semaglutide and placebo. However, semaglutide significantly reduced liver steatosis compared with placebo which, together with improvements in liver enzymes and metabolic parameters, suggests a positive impact on disease activity and metabolic profile.

Author

Anne Flint

Novo Nordisk

Grit Andersen

Profil

Paul Hockings

Chalmers, Electrical Engineering, Signal Processing and Biomedical Engineering

Antaros Medical AB

Lars Johansson

Antaros Medical AB

Anni Morsing

Novo Nordisk

Mads Sundby Palle

Novo Nordisk

Thomas Vogl

University Hospital Frankfurt

Rohit Loomba

University of California at San Diego (UCSD)

Leona Plum-Mörschel

Profil

Alimentary Pharmacology and Therapeutics

0269-2813 (ISSN) 13652036 (eISSN)

Vol. 54 9 1150-1161

Subject Categories

Other Clinical Medicine

Gastroenterology and Hepatology

Radiology, Nuclear Medicine and Medical Imaging

DOI

10.1111/apt.16608

PubMed

34570916

More information

Latest update

4/5/2022 5