Tirzepatide(Mounjaro/Zepbound) and the drugs that are coming to treat obesity (and T2Diabetes) is the main reason the market is not interested in investing in MASH. Obesity is the main risk factor for having fat accumulate in the liver which in turn is the main cause of Fibrosis/Inflammation. Diabetics who are obese are especially at risk. These multi agonist GLP1's are showing promise in reducing liver fat for those that already have it and will theoretically reduce the number of people who develop MASH.
The treatment for MASH before MDGL's rezdiffra became available was weight loss with alcohol intake stopped or at least no more than 30grams a day (2 standard beers). While not especially effective, simple weight loss which is easier said than done, did work at times to stop progression and sometimes reverse the progression (the liver is the only solid organ in the human body that can regenerate itself after damage as it can regrow to its normal size even after up to 90% of it has been removed.)
The jury is out on whether the market sentiment is right here as there are many factors. There are a lot of people who have MASH F2-F4 now and it will be a while before the GLP1's can make a real impact due to supply constraints (5-10 years?) Once you find out you have MASH, do you want to try an "inferior" treatment to see if it works. Plus, genetics can play a role as skinny people can get NASH as well so obesity is not the only cause.
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