Incretin Receptor Agonists Show Promise for Halting Metabolic Dysfunction-Associated Steatotic Liver Disease Progression

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a rapidly growing global health challenge, strongly linked to metabolic syndrome and a leading cause of chronic liver disease. Despite its high risk of progression to advanced fibrosis, there are currently no approved pharmacological treatments, creating a significant clinical unmet need. Incretin-based therapies, initially developed for type 2 diabetes mellitus and obesity, offer a metabolic approach by addressing the core underlying metabolic abnormalities that drive MASLD progression.

This narrative review systematically examined the existing literature on incretin-based therapies, including GLP-1 receptor agonists, GLP-1/GIP dual agonists (e.g., tirzepatide), and emerging GLP-1/GIP/glucagon triagonists (e.g., retatrutide, cotadutide). The authors synthesized evidence regarding their hepatoprotective potential in MASLD, focusing on mechanisms related to weight loss, enhanced insulin sensitivity, and improvements in hepatic steatosis, inflammation, and fibrosis biomarkers.