# Semaglutide in MASH: ESSENCE Phase 3 Results at 72 Weeks | This GLP The ESSENCE phase 3 interim results for semaglutide in MASH, the 13-trial meta-analysis behind them, and the one randomized cirrhosis result that went the other way. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/semaglutide-and-liver-disease Updated: 2026-09-18 Published: 2026-09-16 [← Research](https://thisglp.com/research) Evidence # Semaglutide in MASH: ESSENCE Phase 3 Results at 72 Weeks At 72 weeks, steatohepatitis resolved in 62.9% on semaglutide against 34.3% on placebo, and fibrosis improved in 36.8% against 22.4%. In compensated cirrhosis, the one trial available found neither. [This GLP Editorial Team](https://thisglp.com/about)September 20266 min readUpdated September 2026 Week 72, first 800 patients · steatohepatitis resolved · 62.9% · 34.3% · fibrosis improved · 36.8% · 22.4% · Semaglutide 2.4 mg weekly against placebo. Accent bar is the drug. **Research, not medical advice.** This GLP is independent and educational. Nothing here is a substitute for individualized care from a licensed clinician, and reading it creates no doctor–patient relationship. Talk to your own provider before starting, stopping, or changing any medication, peptide, or therapy. See our [methodology](https://thisglp.com/methodology) and [terms](https://thisglp.com/terms). ## Key takeaways - At 72 weeks, steatohepatitis resolved without worsening fibrosis in 62.9% on semaglutide against 34.3% on placebo — a 28.7 point difference. - Fibrosis improved without worsening steatohepatitis in 36.8% against 22.4%, a 14.4 point difference. - A meta-analysis of 13 trials in 1,811 people put MASH resolution at a pooled odds ratio of 3.48, with no heterogeneity between studies. - In the one trial of MASH-related compensated cirrhosis, semaglutide did neither. - Every one of these results used brand semaglutide at 2.4 mg weekly for over a year. Fatty liver disease is the condition most likely to be sitting underneath a reader’s interest in these drugs without either of them knowing it. More than half the participants in the largest trial also had type 2 diabetes, and almost all met at least one cardiometabolic criterion [\[3\]](https://thisglp.com/research/semaglutide-and-liver-disease#ref-3). It is a common disease that produces no symptoms until it produces serious ones. ## What the phase 3 trial found ESSENCE randomized 1,197 patients with biopsy-defined MASH and fibrosis at stage 2 or 3 in a 2:1 ratio to weekly semaglutide at 2.4 mg or placebo for 240 weeks. A planned interim analysis at week 72, covering the first 800 patients, reported both primary endpoints[\[1\]](https://thisglp.com/research/semaglutide-and-liver-disease#ref-1). Steatohepatitis resolved without worsening of fibrosis in 62.9% of the 534 patients on semaglutide and 34.3% of the 266 on placebo, an estimated difference of 28.7 percentage points (95% CI 21.1 to 36.2). Fibrosis improved without worsening of steatohepatitis in 36.8% against 22.4%, a difference of 14.4 points (95% CI 7.5 to 21.3). Both outcomes together were reached by 32.7% against 16.1%, a difference of 16.5 points (95% CI 10.2 to 22.8). Weight fell 10.5% on semaglutide and 2.0% on placebo. Mean changes in bodily pain scores did not differ between the groups, and gastrointestinal adverse events were more common on the drug — the same pattern the dose-escalation literature describes, which we cover in [titration and nausea](https://thisglp.com/research/how-long-does-nausea-last-on-a-glp1). ## Whether the rest of the class does the same A 2025 meta-analysis pooled 13 phase 2 and phase 3 randomized trials covering 1,811 participants [\[2\]](https://thisglp.com/research/semaglutide-and-liver-disease#ref-2). Among people with MASH and moderate to advanced fibrosis, GLP-1 receptor agonists over up to 72 weeks beat placebo on MASH resolution with a pooled odds ratio of 3.48 (95% CI 2.69 to 4.51) and on fibrosis improvement at 1.79 (95% CI 1.37 to 2.35). Both pooled estimates had an I² of 0%, meaning the trials agreed with each other to an unusual degree. Liver fat measured by magnetic resonance fell by a pooled mean of 4.50% (95% CI 6.60 to 2.40). That estimate came from nine trials with an I² of 95.9% — the studies did not agree, and the pooled number should be read as a direction rather than a quantity. The result that went the other way The same meta-analysis found one randomized trial in people with MASH-related compensated cirrhosis. In that trial semaglutide produced neither MASH resolution nor improved fibrosis against placebo. One trial is not a settled answer, but it is the only randomized evidence there is for that group, and it does not point the same way as everything above. ## What this does and does not tell a buyer Every figure on this page came from 2.4 mg of brand semaglutide given weekly for at least 72 weeks. That is the top of the approved escalation, held for well over a year. Most of the sellers tracked here publish an opening figure and say nothing about what the price becomes at the doses these trials ran at — the gap counted in [who publishes a dose ladder](https://thisglp.com/research/who-publishes-a-glp1-dose-ladder) and listed seller by seller in [published dose ladders](https://thisglp.com/tools/published-dose-ladders). It also tells a buyer what to ask about rather than what to buy. A liver result is not something a telehealth intake form establishes, and the trials selected patients by biopsy. If you are reading this because of a scan result or an enzyme panel, the useful next step is a clinician who can see the panel, not a storefront. The wider question of what the weight trials themselves support is in [what the semaglutide trials are worth](https://thisglp.com/research/semaglutide-cochrane-review), and the kidney outcome data in [semaglutide and kidney disease](https://thisglp.com/research/semaglutide-and-kidney-disease). ## Frequently asked Does semaglutide treat fatty liver disease? In the phase 3 interim analysis, steatohepatitis resolved without worsening fibrosis in 62.9% of patients on semaglutide 2.4 mg against 34.3% on placebo at 72 weeks — a difference of 28.7 percentage points. Does it help if the disease has already reached cirrhosis? The one randomized trial available in MASH-related compensated cirrhosis found neither resolution nor fibrosis improvement against placebo. That is a single trial, and it is the only randomized evidence for that group. What dose did the trials use? Semaglutide 2.4 mg by weekly injection, for 72 weeks in the interim analysis and 240 weeks in the full trial. That is the top of the approved escalation, held for over a year. Do other GLP-1 drugs show the same thing? A meta-analysis of 13 trials in 1,811 people found a pooled odds ratio of 3.48 for MASH resolution and 1.79 for fibrosis improvement, with no heterogeneity between the pooled trials. ## Sources 1. \[1\] Sanyal AJ, et al. (2025). Phase 3 Trial of Semaglutide in Metabolic Dysfunction-Associated Steatohepatitis New England Journal of Medicine. [PMID 40305708](https://pubmed.ncbi.nlm.nih.gov/40305708/) 2. \[2\] Mantovani A, et al. (2025). Glucagon-Like Peptide-1 Receptor Agonists Improve MASH and Liver Fibrosis: A Meta-Analysis of Randomised Controlled Trials Liver International. [PMID 40736113](https://pubmed.ncbi.nlm.nih.gov/40736113/) 3. \[3\] Newsome PN, et al. (2024). Semaglutide 2.4 mg in Participants With Metabolic Dysfunction-Associated Steatohepatitis: Baseline Characteristics and Design of the Phase 3 ESSENCE Trial Alimentary Pharmacology & Therapeutics. [PMID 39412509](https://pubmed.ncbi.nlm.nih.gov/39412509/) ## Where to get it ### Best GLP-1 injections Every injectable seller we can verify, with the price each one publishes and an honest read of what the trials measured. [Compare providers →](https://thisglp.com/best/compounded-semaglutide) ## More in Evidence - [ 150 minutes · Weekly activity goal · 2 days · Muscle strengthening · Adapt · Symptoms and ability ### Exercise on Ozempic: Building Strength Without Ignoring Symptoms ](https://thisglp.com/research/exercise-on-ozempic) - [ STEP 1, semaglutide 2.4 mg vs placebo, % change at 68 weeks · LDL cholesterol · −2.5% vs +1.3% · Total cholesterol · −3.3% vs +0.1% · HDL cholesterol · +5.2% vs +1.4% · Triglycerides · −21.9% vs −7.3% · Wegovy label, Table 13. Adults without diabetes. Ozempic doses are lower. ### Does Ozempic Lower Cholesterol? What the Lipid Results in the Trials Show ](https://thisglp.com/research/does-ozempic-lower-cholesterol) - [ Where the insulin reduction came from, units per day · week 4 · 13.4 total · week 26 · 21.9 · the drug itself · the weight loss · The drug’s own contribution barely moved: 11.1 then 11.4. · Everything added between weeks 4 and 26 came from weight. ### Does Semaglutide Help Type 1 Diabetes? What Two Small Trials Found ](https://thisglp.com/research/semaglutide-in-type-1-diabetes)