Efinopegdutide Makes Liver Scar a Two-Way Street

Key Takeaway

In a 381-patient phase 2b trial, efinopegdutide, a once-weekly injection that activates both the GLP-1 and glucagon receptors, cleared fatty liver inflammation in up to 63% of adults with moderate-to-advanced scarring. Only 13% of patients on placebo saw the same result. At the 7 mg dose, 52% of patients saw their liver scar tissue recede by at least 1 stage within 52 weeks, an early but hopeful signal for a disease that has long had few answers.

The Scar That Was Supposed to Stay

Picture a 53-year-old accountant, the exact average age of the patients in this trial. He drinks little, carries extra weight around his middle and has borderline blood sugar. His liver biopsy shows stage 3 fibrosis: bands of scar tissue bridging across the organ. For most of my career, the honest answer to a patient like him was sobering. Lose 10% of your body weight, and we will hope. Liver scar was treated as a one-way street.

His diagnosis is metabolic dysfunction-associated steatohepatitis, or MASH. It is the inflamed, scarring form of fatty liver disease, which was once called NASH. Fatty liver disease in its…