Weight-loss drug semaglutide could be prescribed to people with a serious form of fatty liver disease under new guidance announced today.
The medication – sold for weight loss under the brand name Wegovy – has been approved by the MHRA to treat metabolic-associated steatohepatitis, or MASH.
MASH develops when excess fat builds up in the liver, triggering inflammation and scarring. It is more common in people who are obese, have type 2 diabetes or have high levels of fat in the blood.
Under the new guidance, semaglutide can be prescribed to adults with MASH who have moderate to advanced liver fibrosis – scarring of the liver caused by the condition.
Julian Beach, Executive Director of Healthcare Quality and Access at the MHRA, said: ‘The available evidence indicates that semaglutide is a safe and effective treatment option for patients with MASH.
‘As with all GLP-1 receptor agonists, this is a prescription-only medication and should only be taken in consultation with a doctor.’
However, patients with MASH cannot currently get semaglutide on the NHS specifically to treat the condition.
NICE is still assessing whether the drug is clinically effective and cost-effective enough to be offered routinely as a treatment for MASH. Until that decision is made, it will not be available on the NHS for this use.
Fatty liver disease is now one of the fastest-growing health problems globally
The approval is also conditional, meaning regulators want more evidence before granting full marketing authorisation. Further results are expected from an ongoing study in adults with MASH and moderate to advanced liver scarring.
Semaglutide is a GLP-1 receptor agonist and is prescribed alongside diet and exercise. It works by mimicking a hormone released after eating, helping people feel fuller for longer, reducing cravings and supporting weight loss.
Semaglutide is already authorised for weight management in adults and adolescents, and for reducing the risk of cardiovascular events in adults.
Treatment usually starts at a low dose of 0.25mg once a week, before gradually increasing to 0.5mg, 1mg and 1.7mg, with patients spending around four weeks on each dose. The usual maintenance dose is 2.4mg once weekly.
For patients with obesity, defined as a BMI over 30, the dose may be increased to 7.2mg once weekly after at least four weeks on the 2.4mg dose.
The MHRA said it will review new information on semaglutide at least once a year, and update the product information if needed.
As with all medicines, the regulator will continue to monitor the drug’s safety and effectiveness. The most common side effects are gastrointestinal problems, including nausea, diarrhoea, constipation and vomiting.
Anyone who thinks they may be experiencing side effects is advised to speak to a doctor, pharmacist or nurse, and report them through the MHRA Yellow Card scheme.
Liver disease is one of the fastest-growing causes of death in the UK, and often develops silently, leaving many unaware until serious and sometimes irreversible damage has already occurred.
Incidents of the disease have soared in recent decades, with deaths increasing more than fourfold since the 1970s – even as outcomes for many other major illnesses have improved.
While it is often linked to alcohol, experts warn growing numbers of cases are being driven by obesity, diabetes and poor diet – meaning millions of non-drinkers could also be at risk.
One of the biggest challenges is that symptoms can take years to appear. By the time the condition is diagnosed, patients may already have significant scarring of the liver, known as cirrhosis, or even liver failure or cancer.
The announcement comes shortly after a tablet form of the medication became available in the UK.
Today Superdrug announced it would be selling the pill for a little as £79 per month.
Around 2.5million adults in the UK are thought to be using fat-busting jabs such as Wegovy and Mounjaro, but the arrival of the new pill has opened the door for millions more.
On average, the lowest dose of the once-weekly injection – 0.25mg – costs between £80 and £140 per month in the UK.
Trial results of the new pill, which is taken daily, found that patients lost around 17 per cent of their body weight after 64 weeks on the highest dose, 25mg.
This means it is slightly less effective than the jabs, which tend to trigger up to a 20.7 per cent reduction.
Superdrug is currently stocking the pill at doses of 1.5mg and 4mg, with higher doses at 9mg and 25mg coming soon.
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