Wegovy MASH benefits seen across patient groups in trial analyses
ESSENCE data show consistent safety and efficacy in key subgroups
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Treatment with Wegovy (semaglutide) showed a consistent safety and efficacy profile across a range of patient subgroups with metabolic dysfunction-associated steatohepatitis (MASH), a serious form of steatotic liver disease (SLD), according to new data from the ESSENCE trial.
Novo Nordisk, the company that sells Wegovy, presented the findings in a series of posters at the European Association for the Study of the Liver (EASL) Annual Congress 2026, held last week in Barcelona, Spain.
“The science we are sharing this week moves us closer to a future where MASH is caught early, treated effectively, and is no longer overlooked. That is what drives us — the people behind these numbers and their unmet needs,” David Ørsted, vice president of global medical affairs obesity and MASH at Novo Nordisk, said in a company press release.
MASH is a form of liver disease in which excess fat buildup in the liver triggers inflammation and tissue scarring (fibrosis) that can eventually lead to liver failure. According to Novo Nordisk, MASH is now one of the leading causes of liver transplants in the Western world.
ESSENCE trial supported Wegovy’s MASH approval
Wegovy is a once-weekly injection therapy that received accelerated approval in the U.S. to treat adults with MASH who have moderate-to-advanced liver fibrosis, but no cirrhosis (severe liver scarring). It is indicated for use in combination with increased physical activity and a reduced-calorie diet.
Wegovy’s approval was based mainly on data from the first part of an ongoing Phase 3 clinical trial called ESSENCE (NCT04822181). At week 72, researchers evaluated efficacy in the first 800 randomized participants with MASH and moderate-to-advanced fibrosis, while safety analyses included all participants in the trial who received at least one dose. Results showed that Wegovy was better than a placebo at reducing signs of liver inflammation and improving fibrosis.
In one poster presentation at the EASL meeting, titled “Semaglutide Shows Favourable Safety Across Subgroups and a Positive Hepatic Safety Profile: Findings from ESSENCE Part 1,” researchers examined the safety profile of Wegovy seen in the ESSENCE study and compared how safety findings differed in different patient subgroups.
Consistent with the therapy’s established safety profile, the analysis showed that gastrointestinal side effects such as nausea, diarrhea, constipation, and vomiting were more common with Wegovy than a placebo.
Nausea, diarrhea, and vomiting had similar median durations with Wegovy and placebo — about a week or less — while constipation lasted longer with Wegovy, about 8.2 months versus 2.7 months with placebo. Gastrointestinal side effects were somewhat more common among patients with less advanced fibrosis and among those without type 2 diabetes.
Researchers also reported no confirmed cases of drug-induced liver injury. Gallbladder-related adverse events were uncommon and mostly mild or nonserious, and no safety finding was seen for pancreatitis.
Japanese subgroup results mirror overall trial findings
In another poster, “Efficacy and safety of semaglutide 2.4 mg in the Japanese subgroup of the ESSENCE study,” investigators analyzed data from Japanese patients in ESSENCE, including 116 who were part of the week 72 efficacy analysis.
According to Novo Nordisk, Asian populations tend to experience MASH at lower body weight and carry unique metabolic and genetic risk profiles, so it’s important to understand how Wegovy works in these patients specifically.
Results from the Japanese subgroup were overall consistent with findings from the overall population. After about 1.5 years, roughly two-thirds of patients given Wegovy in both the Japanese subgroup and the overall trial population achieved MASH resolution without worsening fibrosis, compared with about one-third of those given placebo.
Changes in liver stiffness and other liver-related measures in Japanese patients also largely mirrored those in the overall population.
“In this analysis of ESSENCE (part 1), the efficacy and safety of [Wegovy] in the Japanese subgroup were generally consistent with the overall population,” the researchers concluded.
Menopausal women also show liver health gains
A third poster, “Semaglutide Provides Liver Health-Related Benefits in Menopausal Women Living with MASH: A Post Hoc Analysis of the ESSENCE Trial Part 1,” focused on outcomes from 375 women in ESSENCE who were menopausal. Menopausal women with MASH have an increased risk of advanced liver fibrosis and faster disease progression than women before menopause and men of similar ages.
Results showed that Wegovy led to broadly similar improvements in menopausal women, premenopausal women, and men. In all these groups, the therapy significantly increased the proportion of patients with MASH resolution and improved several other markers of liver health. Liver fibrosis improvement was also seen with Wegovy.
“Menopause does not reduce the likelihood of achieving liver health improvements with [Wegovy],” the researchers concluded.
“Our clinical data … reflect our continued commitment to ensuring that people living with MASH receive timely evidence-based care. A commitment that no patient should fall through the cracks; that women going through menopause deserve evidence-based care for their liver, and that patients in Japan, in the UK, in Germany and across the world deserve access to treatments that work for them,” Ørsted said.
