Introduction: The treatment landscape for metabolic dysfunction-associated steatohepatitis (MASH) is evolving rapidly with the emergence of incretin-based therapies. Beyond improving weight and glycemic control, these agents are showing promise in resolving steatohepatitis and slowing fibrosis progression, raising the question of whether dual-target incretin therapies may outperform GLP-1 receptor agonists alone.
Introduction:
The treatment landscape for metabolic dysfunction-associated steatohepatitis (MASH) is evolving rapidly with the emergence of incretin-based therapies. Beyond improving weight and glycemic control, these agents are showing promise in resolving steatohepatitis and slowing fibrosis progression, raising the question of whether dual-target incretin therapies may outperform GLP-1 receptor agonists alone.
Why was this review needed?
With multiple incretin-based agents now available or in development, clinicians need to understand whether dual agonists offer meaningful advantages over GLP-1 monotherapy and how they compare with other approved therapies such as resmetirom.
What did the review show?
Clinical Impact:
Incretin-based therapies are becoming a major pillar of MASH treatment. Dual-target agents may provide additional metabolic benefits beyond GLP-1 monotherapy, but their long-term impact on fibrosis, treatment duration, and combination strategies remains to be established.
Take-Home Message:
Incretin therapies are reshaping the treatment of MASH. While dual-target agents appear biologically promising and achieve high rates of steatohepatitis resolution, whether two mechanisms are truly better than one for reversing liver fibrosis will require longer-term phase III evidence.
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