In routine practice where repeat biopsy and outcomes data are not available, what longitudinal NIT pattern (e.g., VCTE/ELF ± MRI-PDFF/ALT trajectory) do you consider sufficient to continue semaglutide specifically for MASH, and what trajectory would trigger a “futility” decision to stop or switch despite weight loss?

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Mednet Member

Hepatology · Penn State College of Medicine

Aligned with clinical practice guidance that GLP-1 RAs primarily improve steatosis and inflammation rather than established fibrosis, I look for a concordant metabolic response, including ≥30% PDFF reduction with ALT improvement of ≥17 IU/L or ≥20%, alongside at least stability or modest improvement...