DiabetologiaJul 17, 2026

Drug treatment for metabolic dysfunction-associated fatty liver disease

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Jul 18, 2026

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease worldwide.

MASLD includes conditions like isolated steatosis and advanced fibrosis.
It is strongly associated with type 2 diabetes, cardiovascular disease, chronic kidney disease, and certain cancers.
The condition shares a common origin with cardiometabolic diseases driven by unhealthy diets and insulin resistance.
Substantial differences in MASLD's progression and treatment response may exist due to its varied pathophysiology.
Pharmacological treatments for MASLD/MASH are recommended alongside lifestyle changes.
GLP-1 receptor agonists and SGLT2 inhibitors may improve MASLD/MASH and offer cardiorenal benefits.

Simplified

Metabolic dysfunction-associated steatotic liver disease (MASLD) includes a spectrum of progressive liver conditions ranging from isolated steatosis to metabolic dysfunction-associated steatohepatitis (MASH), advanced fibrosis and cirrhosis. Currently, MASLD is the leading cause of chronic liver disease worldwide. MASLD is strongly associated with type 2 diabetes, cardiovascular disease, chronic kidney disease and certain extrahepatic cancers. MASLD shares a common pathogenesis with cardiometabolic diseases, especially type 2 diabetes, primarily driven by unhealthy dietary habits, dysfunctional adipose tissue, insulin resistance and low-grade inflammation. Substantial heterogeneity in the pathophysiology of MASLD may influence its rate of progression, its relationship with cardiometabolic diseases and its treatment response. In addition to lifestyle interventions, including a healthy low-energy diet and increased physical activity levels, pharmacological treatment of MASLD/MASH is recommended. For individuals with type 2 diabetes and MASLD/MASH, treatment should preferably include glucagon-like peptide-1 (GLP-1) receptor agonist-based therapies and sodium-glucose cotransporter 2 (SGLT2) inhibitors, which have been shown to improve MASLD/MASH and provide established cardiorenal benefits. In this narrative review, we assess the efficacy of these pharmacotherapies and discuss other treatment approaches for MASLD/MASH, with a focus on their metabolic benefits.

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Drug treatment for metabolic dysfunction-associated fatty liver disease

Abstract

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