Condition evidence map
MASLD / MASH (metabolic dysfunction-associated steatotic liver disease)
Research evidence map for MASLD and its progressive form MASH (formerly NAFLD/NASH): hepatic steatosis quantification by MRI-PDFF, biopsy endpoints, and incretin / dual-agonist trial data in MASH.
Research context
MASLD / MASH (renamed from NAFLD / NASH under updated nomenclature) is a major comorbidity of obesity and T2D. Phase 2 trials of GLP-1 and GLP-1/glucagon dual agonists (including survodutide and pemvidutide) report reductions in liver fat by MRI-PDFF and, in some studies, histological improvement. The first US-licensed MASH therapy (resmetirom, a non-peptide thyromimetic) was approved in 2024; incretin-class agents remain investigational for MASH-specific endpoints.
Why this matters metabolically
Hepatic steatosis tracks visceral adiposity and insulin resistance; progression to fibrosis is the clinical concern. Resolution of MASH on biopsy is a regulatory endpoint that incretin-class programmes are pursuing.
FAQs
- Why have NAFLD and NASH been renamed MASLD and MASH?
- The 2023 multi-society consensus replaced the terminology to reflect metabolic dysfunction as the defining feature rather than alcohol exclusion. MASLD = metabolic dysfunction-associated steatotic liver disease; MASH = metabolic dysfunction-associated steatohepatitis.
- Are any incretin medicines licensed for MASH in the UK?
- Not at the time of review. MASH is an active investigational indication for several GLP-1 / dual / triple agonists. Resmetirom is FDA-approved in the US for MASH but is a non-peptide thyromimetic, not an incretin.
- MRI-PDFF reduction does not equal histological MASH resolution.
- Phase 2 hepatic data require phase 3 histology endpoints for regulatory confirmation.
- Weight-driven liver fat reduction does not establish direct hepatic mechanism.
Related mechanisms
Related peptide profiles
Related trials
Related safety signals
Related conditions
Sources are tagged by class. Regulatory documents, peer-reviewed publications and trial registry records are preferred. Manufacturer disclosures and conference material are accepted where peer-reviewed publication is not yet available; preprints are flagged.
- Peer-reviewed publicationJastreboff AM et al. Triple-hormone-receptor agonist retatrutide for obesity — a phase 2 trial. N Engl J Med 2023.
- Peer-reviewed publicationLoomba R et al. Tirzepatide for metabolic dysfunction-associated steatohepatitis with liver fibrosis (SYNERGY-NASH). N Engl J Med 2024.
- Regulatory document (MHRA/EMA/FDA)MHRA — Medicines and Healthcare products Regulatory Agency
UK regulatory authority for medicines and medical devices
- Regulatory document (MHRA/EMA/FDA)NICE — National Institute for Health and Care Excellence
NICE guidance on treatment pathways for metabolic conditions
- Editorial synthesisSite editorial synthesis — Metabolic Peptides
Editorial summary of condition profiles on this site