Introduction: The Evolving Landscape of Metabolic Dysfunction-Associated Steatohepatitis
Metabolic dysfunction-associated steatohepatitis (MASH), formerly known as non-alcoholic steatohepatitis (NASH), has emerged as a global health crisis, paralleling the rise in obesity and type 2 diabetes. As the leading cause of chronic liver disease and a rapidly growing indication for liver transplantation, MASH represents a significant unmet medical need. The pathophysiology of MASH is complex, involving a ‘multi-hit’ process of lipid accumulation, oxidative stress, and inflammatory signaling that ultimately leads to progressive fibrosis and cirrhosis.
Current therapeutic strategies are shifting toward agents that address both the underlying metabolic drivers and the downstream hepatic consequences. While the recent FDA approval of resmetirom marked a milestone, there remains a demand for therapies with more potent metabolic effects and weight-loss benefits. In this context, pemvidutide, a novel GLP-1 and glucagon dual receptor agonist, has garnered significant attention. The 24-week results of the IMPACT trial provide a critical look at the efficacy and safety of this dual-action approach in patients with moderate-to-severe fibrosis.
