Evidence mapPaperPMID 42499082Full record

SynthesisMedicine2026

Therapeutic role of semaglutide in metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis: A systematic review and meta-analysis of placebo-controlled trials with GRADE evidence assessment.

Suleman Khan, Asad Jamal, Maria Qadri, Ibrahim Aslam Zai, Asim Shah, Adil Ahmed, Aizaz Anwar Khalid, Abbas Khan, F N U Misbahuddin, Hammad Iftikhar and 5 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Suleman KhanDepartment of Medicine, Khyber Medical College, Peshawar, Pakistan.
Asad JamalDepartment of Medicine, Khyber Medical College, Peshawar, Pakistan.
Maria QadriDepartment of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
Ibrahim Aslam ZaiDepartment of Medicine, Spinghar Institute of Higher Education, Kabul, Afghanistan.
Asim ShahDepartment of Medicine, Khyber Medical College, Peshawar, Pakistan.
Adil AhmedDepartment of Medicine, Northwest School of Medicine, Peshawar, Pakistan.
Aizaz Anwar KhalidDepartment of Medicine, Peshawar Medical College, Peshawar, Pakistan.
Abbas KhanDepartment of Medicine, Khyber Girls Medical College, Peshawar, Pakistan.
F N U MisbahuddinDepartment of Medicine, Khyber Medical College, Peshawar, Pakistan.
Hammad IftikharDepartment of Medicine, Khyber Medical College, Peshawar, Pakistan.
F N U SawairaDepartment of Medicine, Khyber Girls Medical College, Peshawar, Pakistan.
Muneeb Shad MohmandDepartment of Medicine, Khyber Medical College, Peshawar, Pakistan.
Ibrahim KhalilDepartment of Medicine, Dhaka Medical College and Hospital, Dhaka, Bangladesh.
Mobeen KhanDepartment of Medicine, Khyber Medical College, Peshawar, Pakistan.
Somaiya AhmedDepartment of Internal Medicine, Sir Salimulllah Medical College & Mitford Hospital, Dhaka, Bangladesh.ORCID 0009-0004-4300-5941

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNonalcoholic fatty liver disease (NAFLD) and its progressive form, nonalcoholic steatohepatitis (NASH), are leading causes of chronic liver disease worldwide. Despite the rising clinical burden, there are currently no approved pharmacologic therapies. Semaglutide, a glucagon-like peptide-1 receptor agonist with established metabolic and weight-loss benefits, is being evaluated for potential disease-modifying effects in NAFLD/NASH.

objectiveTo assess the efficacy and tolerability of subcutaneous semaglutide versus placebo in adults with NAFLD or NASH, focusing on biochemical, histologic, metabolic, and safety outcomes.

methodsWe conducted a systematic review and meta-analysis of placebo-controlled randomized controlled trials evaluating subcutaneous semaglutide in adults (≥18 years) with NAFLD or NASH diagnosed by imaging, histology, and/or biochemical markers. PubMed, CENTRAL, and Scopus were searched from inception to May 15, 2025 using predefined terms related to semaglutide and fatty liver disease. Two independent assessors extracted data and evaluated risk of bias using the Cochrane RoB 2 tool, while certainty of evidence was appraised with Grading of Recommendations, Assessment, Development, and Evaluation. Pooled effect estimates were calculated using a random-effects model and reported as risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs).

resultsSemaglutide significantly reduced liver enzymes, including aspartate aminotransferase (MD = -6.72 U/L, 95% CI = -11.79 to -1.64; P = .009). Histologically, semaglutide more than doubled the likelihood of NASH resolution without fibrosis progression (RR = 2.14, 95% CI = 1.44-3.17; P = .0002). Improvement in fibrosis stage was not statistically significant (RR = 1.14, 95% CI = 0.63-2.05; P = .67), though the direction of effect favored semaglutide. Metabolic outcomes showed substantial benefits, including weight loss (MD = -6.99%, 95% CI = -13.92 to -0.06; P = .05) and improved glycated hemoglobin (MD = -1.29%, 95% CI = -1.46 to -1.13; P < .00001). Gastrointestinal adverse events and treatment discontinuation occurred more frequently with semaglutide, while serious adverse events were comparable to placebo (95% CI = 0.81-1.41; P = .64; P = .65).

conclusionSemaglutide demonstrates promising efficacy for NASH resolution and meaningful metabolic improvement with an overall acceptable safety profile. Its effect on fibrosis remains uncertain, and longer-term, adequately powered trials are needed to clarify its role in NAFLD/NASH treatment.

Indexed as

Glucagon-Like PeptidesMetabolic DiseasesNon-alcoholic Fatty Liver DiseaseSemaglutideGlucagon-Like Peptide-1 Receptor AgonistsHumansRandomized Controlled Trials as TopicGlucagon-Like Peptide-1 Receptor AgonistsGlucagon-Like PeptidesSemaglutideGRADEmeta-analysisnonalcoholic fatty liver diseasenonalcoholic steatohepatitisrandomised controlled trialssemaglutidesystematic review

Identifiers

PMID42499082
PMCPMC13406235

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.