Document Type
Letter to the Editor
Publication Date
12-1-2025
Abstract
There has been considerable interest in the potential of GLP-1 agonists for treating chronic liver disease.1 Following the positive results of the Phase 3 ESSENCE trial,2 on August 15, 2025, the FDA-approved Wegovy (semaglutide) for the treatment of metabolic dysfunction–associated steatohepatitis (MASH).3 Recently, the eligibility for semaglutide across all current indications in the United States, including diabetes management, weight management, and secondary prevention of cardiovascular disease (CVD), was estimated to be nearly 137 million individuals based on the National Health and Nutrition Examination Survey (NHANES, 2015–2020).4 Although weight management subsumed all eligibility for secondary prevention of CVD, as well as all but 7.6 million who were eligible for diabetes management, insurance may not cover semaglutide for weight management alone. MASH was omitted from those eligibility estimates, as it had not yet been approved for this indication. In this journal, using the 2017–2020 NHANES cohort, it was reported that up to 8.3 million adults would be eligible for resmetirom, the first FDA-approved drug for MASH,5 and practice guidelines for resmetirom therapy were published in Hepatology.6 Inspired by these reports and the FDA approval of semaglutide for MASH, we analyzed the most recent NHANES cohort (2021–2023) to estimate the number of people in the United States who would be eligible for semaglutide for MASH and compared this to eligibility for diabetes. For comparison, we used vibration-controlled transient elastography (VCTE) cutoffs similar to those of the report on resmetirom,5 as well as more conservative ranges for MASH and moderate-to-advanced liver fibrosis (stages F2–F3) validated against liver biopsy.7
Keywords
metabolic dysfunction–associated steatohepatitis (MASH), National Health and Nutrition Examination Survey, NHANES, nonalcoholic fatty liver disease, semaglutide, steatotic liver disease
Language
English
Publication Title
Hepatology Communications
Grant
HRSA-21-090
Rights
© 2025 TheAuthors. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/), which permits non-commercial copying and redistribution of the material in any medium or format, provided the original work is not changed in any way and is properly cited.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Hughes, Joel W.1; Levin, Jennifer B.2,3; Sajatovic, Martha2,3; Sclair, Seth N.4. Semaglutide for metabolic dysfunction–associated steatohepatitis (MASH): Estimating eligibility from the 2021–2023 National Health and Nutrition Examination Survey (NHANES). Hepatology Communications 9(12):e0860, December 2025. | DOI: 10.1097/HC9.0000000000000860
Manuscript Version
Final Publisher Version