Date of Award

Spring 5-2025

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Staveteig, Mindy

Keywords

nonalcoholic steatohepatitis, NASH, nonalcoholic fatty liver disease, NAFLD, resmetirom, glucagon-like peptide 1 receptor agonist, and GLP-1

Abstract

The incidence of nonalcoholic steatohepatitis (NASH) is continually rising and has now emerged as one of the leading causes of cirrhosis requiring liver transplantation (Maurice et al., 2018). Until recently, the management of this disease has been limited to lifestyle modification and treatment of comorbid risk factors. In March 2024, the FDA approved resmetirom, the first and only medication for the treatment of this condition. The purpose of this literature review is to investigate the efficacy of GLP-1 and dual GLP/GIP or GLP/GCGR receptor agonist medications for the reduction of liver fat content in comparison to resmetirom. A literature review was conducted using electronic databases PubMed and Embase from April to July 2024. Keywords and MeSH terms were used to narrow the literature to studies investigating the use of resmetirom, GLP-1, and dual GLP/GIP/GCGR medications for hepatic fat reduction in participants with nonalcoholic steatohepatitis. Keywords included nonalcoholic steatohepatitis, NASH, nonalcoholic fatty liver disease, NAFLD, resmetirom, glucagon-like peptide 1 receptor agonist, and GLP-1. A database search returned 698 articles. Results were narrowed to 44 articles after the application of filters for randomized controlled trials and publication dates no older than 2014. The remaining articles were manually filtered to yield 11 studies that met the final inclusion criteria. Data reported from the articles included in this review suggests that resmetirom is superior to GLP-1 medications for the improvement of fibrosis in participants with a higher classification of fibrosis, but both medications appear to be equivocal for liver fat reduction in those with lower fibrosis stages and in those with nonalcoholic fatty liver disease, the less severe form of NASH.

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