Semaglutide in metabolic dysfunction-associated steatohepatitis (ESSENCE)

Evidence tier

Established · CKM

Plain-language summary

At 72 weeks (a planned interim analysis of the first 800 of 1,197 patients), more patients on semaglutide achieved resolution of steatohepatitis without worsening fibrosis than on placebo. This is liver (MASH) outcome evidence within the CKM continuum, not a kidney-outcome trial.

Key findings

  • Resolution of steatohepatitis without worsening fibrosis: 62.9% vs 34.3%.
  • Improvement in fibrosis without worsening steatohepatitis: 36.8% vs 22.4%.

Population

Adults with biopsy-defined MASH and fibrosis stage 2–3; semaglutide 2.4 mg weekly; N=1,197 (interim at week 72).

What this does not prove

Liver-histology endpoints, not renal. Interim analysis; weight-loss confounding has been raised. Does not establish kidney benefit.

Primary source

Newsome PN, et al. N Engl J Med. 2025;392:2089.
https://www.nejm.org/doi/abs/10.1056/NEJMoa2413258

Educational only

Paraphrased from the primary publication; not individual medical advice. Verify against the source before applying to care.