LAUSR

"A Placebo-Controlled Trial of Subcutaneous Semaglutide in Nonalcoholic Steatohepatitis (1)," recently published in the New England Journal of Medicine (online November 2020) by Newsome et al., is an important investigation of the impact of 72 weeks of the glucagon-like peptide-1 (GLP-1) receptor agonist semaglutide compared to placebo in patients with biopsy proven nonalcoholic steatohepatitis (NASH) and liver fibrosis (F1-3). GLP-1 receptor agonists are slightly modified peptides that are resistant to degradation by the dipeptidyl peptidase-4 enzyme but that mimic the effects of endogenous GLP-1, including increasing insulin secretion, decreasing glucagon production and hepatic glucose production, slowing gastric emptying and decreasing appetite (2). Drugs in this class are currently FDA approved for the treatment of type 2 diabetes (T2DM) and for weight loss in individuals both with and without T2DM (3) but are not specifically approved for the treatment of NASH. GLP-1 receptor agonists are a particularly attractive potential therapeutic option in NASH given their beneficial glycemic and weight loss effects.