A comprehensive review outlines current and emerging pharmacotherapies for MASLD, highlighting GLP-1 receptor agonists like semaglutide and tirzepatide as promising treatment options alongside lifestyle changes.
6+ drug classesPharmacological agents reviewed for MASLD treatment, with GLP-1 receptor agonists and dual incretin agonists among the most promising
What the researchers found
The review identifies several pharmacological agents showing encouraging clinical trial results for MASLD treatment: resmetirom (a thyroid hormone receptor-β agonist), GLP-1 receptor agonists like semaglutide, PPAR agonists (pioglitazone, saroglitazar), SGLT2 inhibitors, and vitamin E. Emerging therapies including tirzepatide (dual incretin agonist) and FGF analogs are highlighted as potentially transformative.
A structured treatment algorithm for non-cirrhotic MASLD (F0-F3 fibrosis) is presented, incorporating only drugs available in India and stratified by diabetes status and fibrosis severity.
Why it matters
MASLD affects a large and growing portion of the global population, driven by rising obesity and diabetes rates. With peptide-based therapies like GLP-1 receptor agonists and dual incretin agonists emerging as key treatment options, this review helps contextualize how these peptide drugs fit into the broader treatment landscape for a major liver disease.
How the study worked
This is a narrative review that synthesizes evidence from clinical trials and current literature on MASLD pharmacotherapy. The authors developed a practical treatment algorithm based on available evidence, tailored specifically for clinical use in India considering drug availability, cost-effectiveness, and real-world feasibility.
What this study cannot tell us
As a narrative review, it does not include a systematic search methodology or meta-analysis. The treatment algorithm is tailored for India and may not directly apply to other healthcare settings. The review focuses on drugs available in India, potentially omitting therapies accessible elsewhere. Long-term safety and efficacy data for many emerging agents remain limited.
How to read the evidence
This is a narrative review article synthesizing existing clinical trial evidence. While it provides a useful clinical overview and treatment algorithm, it does not generate new primary data and lacks the systematic rigor of a systematic review or meta-analysis.
When this study was published
Published in 2025, this review reflects the most current landscape of MASLD pharmacotherapy, including recently approved drugs and drugs in late-stage clinical trials.
The bigger picture
This review reflects a pivotal moment in MASLD treatment where peptide-based therapies — particularly GLP-1 receptor agonists and dual incretin agonists — are becoming central to managing a disease that was previously treated almost exclusively through lifestyle modification. The approval of resmetirom and the strong clinical data behind semaglutide and tirzepatide signal a new era of targeted pharmacotherapy for fatty liver disease.
Questions still open
- How do GLP-1 receptor agonists compare head-to-head with resmetirom for MASLD treatment outcomes?
- Will dual incretin agonists like tirzepatide prove superior to single-target GLP-1RAs for liver-specific outcomes?
- Can cost-effective peptide therapies be made accessible in developing countries where MASLD prevalence is rapidly rising?
Common questions
What is MASLD and why are peptide therapies relevant?
Which peptide-based treatments show the most promise for fatty liver disease?
Read the original research
MASLD Pharmacotherapy: Current Standards, Emerging Treatments, and Practical Guidance for Indian Physicians.
The Journal of the Association of Physicians of India, 73(7), e45-e60
Citation
Kumar, Ashish. (2025). MASLD Pharmacotherapy: Current Standards, Emerging Treatments, and Practical Guidance for Indian Physicians.. The Journal of the Association of Physicians of India, 73(7), e45-e60. https://doi.org/10.59556/japi.73.1058