Therapeutic role of semaglutide in metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis: A systematic review and meta-analysis of placebo-controlled trials with GRADE evidence assessment.

Khan S, Jamal A, Qadri M, Zai IA, Shah A, Ahmed A, Khalid AA, Khan A, Misbahuddin FNU, Iftikhar H, Sawaira FNU, Mohmand MS, Khalil I, Khan M, Ahmed S

Medicine1 Jul 2026

PMID42499082PMCIDPMC13406235DOI10.1097/md.0000000000049916PepBankPUB-42499082

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Summary

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Text rights: CC BY-NC. Results still quote short attributed sentences.

Results from this study8

8 results from studies that gave the peptide. 8 results from people.

01HumanSystematic reviewEfficacy outcome
In adults with NAFLD or NASH, pooled trials showed semaglutide lowered aspartate aminotransferase versus placebo (MD -6.72 U/L).
In plain wordsIn adults with fatty liver disease, semaglutide lowered the liver enzyme AST more than placebo across pooled trials.
Peptide
Semaglutide
Outcome
DecreaseAspartate aminotransferase
Study
n: not reported in source
Comparator
Placebo
Outcome group
Liver fat and liver function · Liver
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Measurements
Mean difference in AST
−6.72 U/L
semaglutide versus placebo
Source sentences
Summary
Semaglutide significantly reduced liver enzymes, including aspartate aminotransferase (MD = -6.72 U/L, 95% CI = -11.79 to -1.64; P = .009).
1 context sentence(design, population, supporting numbers)
Summary · context
We conducted a systematic review and meta-analysis of placebo-controlled randomized controlled trials evaluating subcutaneous semaglutide in adults (≥18 years) with NAFLD or NASH diagnosed by imaging, histology, and/or biochemical markers.
Report a problemFND-4249908201
02HumanSystematic reviewEfficacy outcome
In adults with NASH, pooled trials showed semaglutide more than doubled the likelihood of NASH resolution without fibrosis progression versus placebo (RR 2.14).
In plain wordsIn adults with NASH, semaglutide made NASH resolution without worse fibrosis more than twice as likely as placebo across pooled trials.
Peptide
Semaglutide
Outcome
IncreaseNASH resolution without fibrosis progression
Study
n: not reported in source
Comparator
Placebo
Outcome group
Liver fat and liver function · Liver
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Measurements
Risk ratio
2.14
NASH resolution without fibrosis progression
Source sentences
Summary
Histologically, semaglutide more than doubled the likelihood of NASH resolution without fibrosis progression (RR = 2.14, 95% CI = 1.44-3.17; P = .0002).
1 context sentence(design, population, supporting numbers)
Summary · context
We conducted a systematic review and meta-analysis of placebo-controlled randomized controlled trials evaluating subcutaneous semaglutide in adults (≥18 years) with NAFLD or NASH diagnosed by imaging, histology, and/or biochemical markers.
Report a problemFND-4249908202
03HumanSystematic reviewEfficacy outcome
In adults with NASH, pooled trials found no statistically significant improvement in fibrosis stage with semaglutide versus placebo (RR 1.14).
In plain wordsIn adults with NASH, semaglutide did not significantly improve liver fibrosis stage compared with placebo across pooled trials.
Peptide
Semaglutide
Outcome
No significant changeFibrosis stage improvement
Study
n: not reported in source
Comparator
Placebo
Outcome group
Liver fat and liver function · Liver
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Measurements
Risk ratio
1.14
fibrosis stage improvement
Source sentences
Summary
Improvement in fibrosis stage was not statistically significant (RR = 1.14, 95% CI = 0.63-2.05; P = .67), though the direction of effect favored semaglutide.
1 context sentence(design, population, supporting numbers)
Summary · context
We conducted a systematic review and meta-analysis of placebo-controlled randomized controlled trials evaluating subcutaneous semaglutide in adults (≥18 years) with NAFLD or NASH diagnosed by imaging, histology, and/or biochemical markers.
Report a problemFND-4249908203
04HumanSystematic reviewEfficacy outcome
In adults with NAFLD or NASH, pooled trials showed semaglutide reduced body weight versus placebo (MD -6.99%).
In plain wordsIn adults with fatty liver disease, semaglutide led to more weight loss than placebo across pooled trials.
Peptide
Semaglutide
Outcome
DecreaseWeight loss
Study
n: not reported in source
Comparator
Placebo
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Measurements
Mean difference in weight
−6.99%
semaglutide versus placebo
Source sentences
Summary
weight loss (MD = -6.99%, 95% CI = -13.92 to -0.06; P = .05)
1 context sentence(design, population, supporting numbers)
Summary · context
We conducted a systematic review and meta-analysis of placebo-controlled randomized controlled trials evaluating subcutaneous semaglutide in adults (≥18 years) with NAFLD or NASH diagnosed by imaging, histology, and/or biochemical markers.
Report a problemFND-4249908204
05HumanSystematic reviewEfficacy outcome
In adults with NAFLD or NASH, pooled trials showed semaglutide lowered glycated hemoglobin versus placebo (MD -1.29%).
In plain wordsIn adults with fatty liver disease, semaglutide lowered HbA1c more than placebo across pooled trials.
Peptide
Semaglutide
Outcome
DecreaseGlycated hemoglobin
Study
n: not reported in source
Comparator
Placebo
Outcome group
Glycemic control · Metabolic and weight
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Measurements
Mean difference in HbA1c
−1.29%
semaglutide versus placebo
Source sentences
Summary
improved glycated hemoglobin (MD = -1.29%, 95% CI = -1.46 to -1.13; P < .00001)
1 context sentence(design, population, supporting numbers)
Summary · context
We conducted a systematic review and meta-analysis of placebo-controlled randomized controlled trials evaluating subcutaneous semaglutide in adults (≥18 years) with NAFLD or NASH diagnosed by imaging, histology, and/or biochemical markers.
Report a problemFND-4249908205
06HumanSystematic reviewSafety outcome
In adults with NAFLD or NASH, gastrointestinal adverse events occurred more often with semaglutide than with placebo in pooled trials.
In plain wordsIn adults with fatty liver disease, stomach and gut side effects were more common with semaglutide than with placebo.
Peptide
Semaglutide
Outcome
IncreaseGastrointestinal adverse events
Study
n: not reported in source
Comparator
Placebo
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Source sentences
Summary
Gastrointestinal adverse events and treatment discontinuation occurred more frequently with semaglutide
1 context sentence(design, population, supporting numbers)
Summary · context
We conducted a systematic review and meta-analysis of placebo-controlled randomized controlled trials evaluating subcutaneous semaglutide in adults (≥18 years) with NAFLD or NASH diagnosed by imaging, histology, and/or biochemical markers.
Report a problemFND-4249908206
07HumanSystematic reviewSafety outcome
In adults with NAFLD or NASH, treatment discontinuation occurred more often with semaglutide than with placebo in pooled trials.
In plain wordsIn adults with fatty liver disease, more people stopped treatment with semaglutide than with placebo.
Peptide
Semaglutide
Outcome
IncreaseTreatment discontinuation
Study
n: not reported in source
Comparator
Placebo
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Source sentences
Summary
Gastrointestinal adverse events and treatment discontinuation occurred more frequently with semaglutide
1 context sentence(design, population, supporting numbers)
Summary · context
We conducted a systematic review and meta-analysis of placebo-controlled randomized controlled trials evaluating subcutaneous semaglutide in adults (≥18 years) with NAFLD or NASH diagnosed by imaging, histology, and/or biochemical markers.
Report a problemFND-4249908207
08HumanSystematic reviewSafety outcome
In adults with NAFLD or NASH, serious adverse events with semaglutide were comparable to placebo in pooled trials.
In plain wordsIn adults with fatty liver disease, serious side effects with semaglutide were similar to placebo.
Peptide
Semaglutide
Outcome
No significant changeSerious adverse events
Study
n: not reported in source
Comparator
Placebo
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Source sentences
Summary
while serious adverse events were comparable to placebo (95% CI = 0.81-1.41; P = .64; P = .65).
1 context sentence(design, population, supporting numbers)
Summary · context
We conducted a systematic review and meta-analysis of placebo-controlled randomized controlled trials evaluating subcutaneous semaglutide in adults (≥18 years) with NAFLD or NASH diagnosed by imaging, histology, and/or biochemical markers.
Report a problemFND-4249908208

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
11 Oct 2026, 00:04 UTC
Study results updated
Version 1
9 Oct 2026, 03:06 UTC
First added · source update from Europe PMC

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