{"id":31474,"date":"2025-04-14T17:20:00","date_gmt":"2025-04-14T11:50:00","guid":{"rendered":"https:\/\/www.delveinsight.com\/blog\/?p=31474"},"modified":"2025-04-14T15:21:17","modified_gmt":"2025-04-14T09:51:17","slug":"emerging-obesity-targeted-therapies-for-mash","status":"publish","type":"post","link":"https:\/\/www.delveinsight.com\/blog\/emerging-obesity-targeted-therapies-for-mash","title":{"rendered":"Redefining Liver Disease in the Metabolic Era: From NASH to MASH and the Rise of Obesity\u2010targeted Therapies"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_76 counter-hierarchy ez-toc-counter ez-toc-white ez-toc-container-direction\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<label for=\"ez-toc-cssicon-toggle-item-6a0a5f9f7d77f\" class=\"ez-toc-cssicon-toggle-label\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/label><input type=\"checkbox\"  id=\"ez-toc-cssicon-toggle-item-6a0a5f9f7d77f\"  aria-label=\"Toggle\" \/><nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.delveinsight.com\/blog\/emerging-obesity-targeted-therapies-for-mash\/#The_Nomenclature_Evolution\" >The Nomenclature Evolution<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.delveinsight.com\/blog\/emerging-obesity-targeted-therapies-for-mash\/#Obesity-targeted_Therapies_and_Their_Impact_on_MASH\" >Obesity-targeted Therapies and Their Impact on MASH<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.delveinsight.com\/blog\/emerging-obesity-targeted-therapies-for-mash\/#Comparative_Efficacy_of_Semaglutide_and_Tirzepatide_in_Managing_Obesity-Driven_MASLD\" >Comparative Efficacy of Semaglutide and Tirzepatide in Managing Obesity-Driven MASLD<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.delveinsight.com\/blog\/emerging-obesity-targeted-therapies-for-mash\/#Early_Clinical_Data\" >Early Clinical Data&nbsp;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.delveinsight.com\/blog\/emerging-obesity-targeted-therapies-for-mash\/#Strategic_Shift_Efinopegdutides_Development_Focus_from_Obesity_to_MASH\" >Strategic Shift: Efinopegdutide\u2019s Development Focus from Obesity to MASH<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.delveinsight.com\/blog\/emerging-obesity-targeted-therapies-for-mash\/#KOL_Perspective\" >KOL Perspective<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.delveinsight.com\/blog\/emerging-obesity-targeted-therapies-for-mash\/#Conclusion_and_Future_Outlook_of_Liver_Disease\" >Conclusion and Future Outlook of Liver Disease<\/a><\/li><\/ul><\/nav><\/div>\n\n<p>The paradigm shift from <strong>Non\u2010alcoholic Steatohepatitis (NASH)<\/strong> to <strong>Metabolic Dysfunction\u2013associated Steatohepatitis (MASH)<\/strong> reflects a deeper understanding of the pathophysiology underpinning liver injury in the context of obesity, diabetes, and metabolic syndrome. This evolving nomenclature from <a href=\"https:\/\/www.delveinsight.com\/blog\/from-nash-to-mash\">NASH to MASH<\/a> is more than a semantic update\u2014it mirrors a fundamental change in how we conceptualize liver disease, moving away from a definition based solely on the exclusion of alcohol consumption toward one that highlights the central role of metabolic dysregulation.&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-the-nomenclature-evolution\"><span class=\"ez-toc-section\" id=\"The_Nomenclature_Evolution\"><\/span><strong>The Nomenclature Evolution<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Historically, liver conditions characterized by steatosis with inflammation were labeled as NASH, with the broader term Non\u2010alcoholic Fatty Liver Disease (NAFLD) covering the entire spectrum. However, as research increasingly implicated metabolic abnormalities\u2014such as insulin resistance, dyslipidemia, and obesity\u2014as key drivers of liver injury, experts recognized that the term \u2018nonalcoholic\u2019 was both misleading and insufficient. In response, a consensus emerged to rename the condition<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>MASLD (Metabolic Dysfunction\u2013Associated Steatotic Liver Disease):<\/strong> This umbrella term encompasses the entire spectrum of fatty liver disease where metabolic dysfunction is the primary instigator.&nbsp;<\/li>\n\n\n\n<li><strong>MASH:<\/strong> This refers specifically to the inflammatory and progressive stage of MASLD, where hepatocellular injury and fibrosis are prominent.<\/li>\n<\/ul>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>This change aligns with the mounting evidence that the metabolic milieu\u2014not merely the absence of alcohol\u2014is crucial in driving liver pathology. It also emphasizes that patients with obesity, diabetes, and metabolic syndrome are at the highest risk, a fact that is driving both diagnostic and therapeutic innovations.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-obesity-targeted-therapies-and-their-impact-on-mash\"><span class=\"ez-toc-section\" id=\"Obesity-targeted_Therapies_and_Their_Impact_on_MASH\"><\/span><strong>Obesity-targeted Therapies and Their Impact on MASH<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Given the tight link between metabolic syndrome and liver injury, obesity-targeted drugs have emerged as <a href=\"https:\/\/www.delveinsight.com\/blog\/promising-late-stage-nash-drugs\">promising candidates for treating MASH<\/a>. Medications initially created for diabetes and weight loss are now being repurposed to help reduce liver fat buildup, inflammation, and fibrosis.<\/p>\n\n\n\n<p><strong>GLP\u20111 Receptor Agonists:<\/strong> Agents such as <strong>semaglutide <\/strong>improve insulin sensitivity, suppress appetite, and reduce de novo lipogenesis, thereby reducing liver fat and inflammation.<\/p>\n\n\n\n<p><strong>Dual\/Triple Receptor Agonists: Tirzepatide <\/strong>(a GLP\u20111\/GIP dual agonist) and emerging candidates like <strong>efinopegdutide and survodutide<\/strong> target multiple receptors to produce synergistic metabolic effects.<\/p>\n\n\n\n<p><strong>SGLT2 Inhibitors: <\/strong>Originally designed for glycemic control, these drugs also show potential in reducing hepatic steatosis and inflammation.<\/p>\n\n\n\n<p>Together, these therapies represent a multifaceted approach to counteracting the metabolic drivers of liver disease, potentially halting\u2014or even reversing\u2014fibrosis progression.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-comparative-efficacy-of-semaglutide-and-tirzepatide-in-managing-obesity-driven-masld\"><span class=\"ez-toc-section\" id=\"Comparative_Efficacy_of_Semaglutide_and_Tirzepatide_in_Managing_Obesity-Driven_MASLD\"><\/span><strong>Comparative Efficacy of Semaglutide and Tirzepatide in Managing Obesity-Driven MASLD<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>Both <strong>semaglutide and tirzepatide<\/strong> have emerged as potent obesity therapies with significant implications for managing MASH. Their robust weight loss effects\u2014an essential driver in improving liver histology in MASLD\u2014reflect distinct mechanisms and clinical outcomes.<\/p>\n\n\n\n<p><strong>Novo Nordisk and Eli Lilly<\/strong> are pushing the boundaries in the MASLD treatment space by investigating these two transformative <a href=\"https:\/\/www.delveinsight.com\/blog\/obesity-drugs-launch\">obesity drugs<\/a> for their potential to reverse liver injury in MASH.<\/p>\n\n\n\n<p>Novo Nordisk is currently evaluating semaglutide in the <strong>Phase III ESSENCE trial (NCT04822181)<\/strong>, a 240-week double-blind study in 1,200 adults with MASH and moderate to advanced liver fibrosis (Stage II or III). In Part 1 of the trial, liver biopsy data from the first 800 randomized patients at Week 72 revealed that once-weekly semaglutide 2.4\u202fmg produced statistically significant histological improvements: 37.0% of patients experienced an improvement in liver fibrosis without worsening steatohepatitis, compared with 22.5% on placebo, while 62.9% achieved resolution of steatohepatitis without fibrosis worsening versus 34.1% on placebo. Semaglutide\u2019s safety profile was consistent with earlier studies, with no new concerns arising, and its promise was underscored in August 2020 when the US FDA granted it BTD for NASH. The trial successfully met its primary endpoints, showing a statistically significant and superior improvement in liver fibrosis without worsening steatohepatitis. Additionally, it achieved steatohepatitis resolution with no deterioration in liver fibrosis. Novo Nordisk plans to seek regulatory approvals in the US and EU in the first half of 2025.<\/p>\n\n\n\n<p>In parallel, Eli Lilly\u2019s tirzepatide\u2014approved as <strong>MOUNJARO <\/strong>for type 2 diabetes and as <strong>ZEPBOUND <\/strong>for obesity\u2014was assessed in the <strong>Phase II SYNERGY-NASH trial (NCT04166773).<\/strong> This multicenter, double-blind, placebo-controlled study enrolled adults with biopsy-confirmed MASH and Stage II or III fibrosis. At Week 52, the trial\u2019s primary endpoint, MASH resolution without worsening fibrosis, was achieved by 51.8%, 62.8%, and 73.3% of patients receiving tirzepatide at doses of 5\u202fmg, 10\u202fmg, and 15\u202fmg, respectively, compared to only 13.2% in the placebo group. For the secondary endpoint\u2014fibrosis improvement without worsening MASH\u2014response rates were 59.1%, 53.3%, and 54.2% at the respective doses versus 32.8% with the placebo. Significant improvements in body weight, liver injury markers, and metabolic parameters accompanied these robust efficacy signals. Importantly, tirzepatide\u2019s safety profile mirrored that observed in previous trials (such as <strong>SURMOUNT and SURPASS<\/strong>), with adverse gastrointestinal events (nausea, diarrhea, decreased appetite, and constipation) remaining mild to moderate.<\/p>\n\n\n\n<p>Taken together, these studies underscore a paradigm shift; while both semaglutide and tirzepatide demonstrate promise in improving liver fibrosis, tirzepatide\u2019s dual receptor agonism appears to confer even greater benefits in terms of weight loss and metabolic improvement. As further data emerge, these agents may well redefine MASLD management\u2014offering not only a means to address obesity and metabolic dysfunction but also to directly ameliorate liver pathology, thereby reducing the long-term burden of this increasingly prevalent disease.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-early-clinical-data-nbsp\"><span class=\"ez-toc-section\" id=\"Early_Clinical_Data\"><\/span><strong>Early Clinical Data<\/strong><strong>&nbsp;<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p><strong>Survodutide (BI 456906)<\/strong> is a novel dual agonist targeting both GLP-1 and glucagon receptors, developed collaboratively by <strong>Boehringer Ingelheim and Zealand Pharma<\/strong>. In a Phase II <a href=\"https:\/\/www.delveinsight.com\/blog\/nash-emerging-therapies\">NASH clinical trial<\/a> involving adults with MASH, up to 83% of participants treated with survodutide achieved significant histological improvement in MASH without worsening fibrosis, compared to 18.2% in the placebo group. Additionally, survodutide demonstrated substantial reductions in liver fat content and fibrosis markers, with up to 64.5% of patients with fibrosis Stages F2 and F3 showing improvement without MASH progression versus 25.9% with placebo. These findings suggest that survodutide holds promise as an effective treatment for MASH, addressing both liver inflammation and fibrosis.<\/p>\n\n\n\n<p><strong>Efinopegdutide (MK-6024)<\/strong> is an investigational dual agonist targeting both GLP-1 and glucagon receptors, developed by Merck &amp; Co. in collaboration with <strong>Hanmi Pharmaceutical<\/strong>. In a Phase IIa clinical trial involving patients with NAFLD, efinopegdutide 10 mg weekly led to a 72.7% reduction in liver fat content over 24 weeks, significantly outperforming semaglutide 1 mg weekly, which achieved a 42.3% reduction. These results highlight efinopegdutide\u2019s potential as an effective treatment for NAFLD and its more severe form, NASH, warranting further investigation in larger clinical trials.<\/p>\n\n\n\n<p><strong>Altimmune\u2019s Pemvidutide<\/strong> is emerging as another promising therapeutic candidate in the fight against MASH. This investigational drug is a balanced dual agonist that targets both the GLP-1 and glucagon receptors. Its unique design incorporates a glycolipid surfactant conjugation, which extends its half-life and permits once\u2010weekly dosing. Preclinical studies in mouse models of MASH demonstrated impressive efficacy\u2014with marked reductions in liver fat content and liver volume\u2014and these promising findings have translated into early clinical success. In a recent Phase Ib study involving patients with NAFLD, Pemvidutide achieved an approximate 75% reduction in liver fat content over 6 months, suggesting potent anti-steatotic and potentially anti-inflammatory effects.<\/p>\n\n\n\n<p>Building on these encouraging results, Altimmune has advanced pemvidutide into a Phase IIb study\u2014the <strong>IMPACT NASH trial (NCT05989711)<\/strong>\u2014which is evaluating histological endpoints in approximately 190 MASH patients. This study will help determine whether Pemvidutide can not only reduce liver fat but also improve fibrosis and resolve steatohepatitis. If successful, Pemvidutide could represent a vital addition to the <a href=\"https:\/\/www.delveinsight.com\/blog\/nash-commercial-activities\">emerging therapeutic landscape for MASH<\/a>, complementing agents like semaglutide and tirzepatide by offering another mechanism to target both metabolic dysfunction and liver injury directly.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Retatrutide <\/strong>is an investigational triple agonist targeting GIP, GLP-1, and glucagon receptors, developed by Eli Lilly. In a Phase II clinical trial involving adults with obesity and MASLD, retatrutide demonstrated a significant reduction in liver fat content. At 24 weeks, participants receiving the 12 mg dose experienced an 82.4% decrease in liver fat, compared to a 0.3% increase in the placebo group.<\/p>\n\n\n\n<p><span id=\"docs-internal-guid-4a13b059-7fff-eb28-92c9-381e3c9e61e8\"><\/span><\/p>\n<div dir=\"ltr\" style=\"margin-left: 0pt;\" align=\"left\">\n<table style=\"border: none; border-collapse: collapse;\"><colgroup><col width=\"105\" \/><col width=\"5\" \/><col width=\"51\" \/><col width=\"150\" \/><col width=\"111\" \/><col width=\"102\" \/><col width=\"99\" \/><\/colgroup>\n<tbody>\n<tr style=\"height: 20.936pt;\">\n<td style=\"vertical-align: top; background-color: #bee6ff; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\" colspan=\"7\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: center; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Obesity-based MASH Therapies<\/span><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 0pt;\">\n<td style=\"vertical-align: top; background-color: #bee6ff; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Drug Name<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #bee6ff; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\" colspan=\"2\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Phase<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #bee6ff; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Company<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #bee6ff; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">MoA<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #bee6ff; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Key Clinical Data<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #bee6ff; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Notable Outcomes<\/span><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 0pt;\">\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Semaglutide<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\" colspan=\"2\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">III<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Novo Nordisk<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">GLP-1 receptor agonist<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Approximately 37% improvement in liver fibrosis versus ~22% placebo (Phase III ESSENCE trial)<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Significant improvement in liver histology and reduction in hepatic fat<\/span><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 0pt;\">\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Tirzepatide<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\" colspan=\"2\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">II<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Eli Lilly<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Dual GLP-1\/GIP receptor agonist<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Resolution rates up to 73.3% vs. 13.2% placebo in SYNERGY-NASH trial<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Dose-dependent MASH resolution, fibrosis improvement, and liver health benefits.<\/span><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 0pt;\">\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Survodutide<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\" colspan=\"2\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">III<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Boehringer Ingelheim\/Zealand Pharma<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Dual GLP-1\/Glucagon receptor agonist<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Up to 83% of patients showed histological improvement (Phase II trial)<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Strong reduction in liver fat and fibrosis markers<\/span><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 0pt;\">\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Efinopegdutide<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\" colspan=\"2\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">II<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Hanmi Pharmaceutical\/Merck<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Synthetic GLP-1\/GCG conjugate via PEG linker<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">~72.7% reduction in liver fat at 24 weeks (Phase IIa trial)<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Promising anti-steatotic effects<\/span><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 0pt;\">\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Pemvidutide<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\" colspan=\"2\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">II<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Altimmune<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Dual GLP-1\/GCGR agonist<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">~75% reduction in liver fat over 6 months (early clinical data)<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Significant anti-steatotic and anti-inflammatory effects<\/span><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 0pt;\">\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Retatrutide<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\" colspan=\"2\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">II<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Eli Lilly<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Triple agonist of the GIP, glucagon-like peptide 1, and glucagon receptors.<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Change from baseline in LF at 24&thinsp;weeks was &minus;82.4% (12&thinsp;mg) compared to +0.3% (placebo) (Phase II trial)<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Significantly reduced liver fat<\/span><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 20.936pt;\">\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\" colspan=\"7\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Early Potential Assets<\/span><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 0pt;\">\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">AZD9550<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\" colspan=\"2\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">I\/II<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">AstraZeneca<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">GLP-1R glucagon dual agonist<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">&#8211;<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">&#8211;<\/span><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 0pt;\">\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">VK2735<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\" colspan=\"2\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">I<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Viking Therapeutics<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Dual GLP-1\/GIP agonist<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">&#8211;<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">&#8211;<\/span><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 0pt;\">\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Danuglipron (PF-06882961)<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\" colspan=\"2\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">I<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Pfizer<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">GLP-1R agonist<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">&#8211;<\/span><\/p>\n<\/td>\n<td style=\"vertical-align: top; background-color: #f5f5f5; padding: 4.968pt 4.968pt 4.968pt 4.968pt; overflow: hidden; overflow-wrap: break-word; border: solid #000000 1pt;\">\n<p dir=\"ltr\" style=\"line-height: 1.2; text-align: justify; margin-top: 10pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">&#8211;<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Strategic_Shift_Efinopegdutides_Development_Focus_from_Obesity_to_MASH\"><\/span><strong>Strategic Shift: Efinopegdutide\u2019s Development Focus from Obesity to MASH<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p><strong>Efinopegdutide <\/strong>is an investigational dual agonist targeting both GLP-1 and glucagon receptors, developed by Merck in collaboration with Hanmi Pharmaceutical, currently under clinical investigation for the treatment of NAFLD and NASH. In a Phase IIa study, efinopegdutide demonstrated a significant reduction in liver fat content compared to semaglutide, another <a href=\"https:\/\/www.delveinsight.com\/report-store\/glucagon-like-peptide1-glp1-agonists-market-forecast\">GLP-1 receptor agonist<\/a>, suggesting its potential efficacy in treating NASH.&nbsp;<\/p>\n\n\n\n<p>In earlier <a href=\"https:\/\/www.delveinsight.com\/blog\/emerging-therapies-for-obesity-treatment\">obesity clinical trials<\/a>, efinopegdutide exhibited promising weight loss results. However, these studies reported a relatively high incidence of adverse gastrointestinal events, leading to a notable discontinuation rate among participants. Specifically, 24.5% of participants in a Phase II obesity trial discontinued efinopegdutide at a 10 mg dose due to adverse events.&nbsp;<\/p>\n\n\n\n<p>These safety concerns have contributed to a strategic shift in focus towards MASH, where efinopegdutide\u2019s dual agonist mechanism may offer more targeted therapeutic benefits with a potentially improved risk-benefit profile.<\/p>\n\n\n\n<p>The strategic prioritization of efinopegdutide\u2019s development for MASH over obesity reflects a nuanced consideration of therapeutic potential and market dynamics. MASH represents a significant unmet medical need, with limited approved therapies and a growing patient population at risk of progressing to cirrhosis and liver-related complications. The robust efficacy signals observed in liver fat reduction position efinopegdutide as a promising candidate in this space. Conversely, the obesity treatment landscape has become increasingly competitive, with several GLP-1 receptor agonists already approved and demonstrating substantial efficacy. By focusing on MASH, companies can leverage efinopegdutide\u2019s unique dual agonist properties to address a critical gap in treatment options, potentially expediting regulatory approvals and optimizing resource allocation. This strategic decision underscores a targeted approach to drug development, aligning clinical benefits with areas of highest unmet need.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"KOL_Perspective\"><\/span><strong>KOL Perspective<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The strong efficacy of survodutide in improving MASH and fibrosis underscores the growing role of glucagon receptor agonism in liver disease treatment. With an 83% response rate in a mid-stage trial, survodutide reinforces the hypothesis that glucagon\u2019s ability to reduce liver fat is clinically meaningful. The competitive landscape is shifting, with dual and triple agonists like tirzepatide and retatrutide showing metabolic benefits. However, concerns over cardiovascular safety with retatrutide may give survodutide a strategic advantage, positioning it as a leading candidate in the evolving MASH market.<\/p>\n\n\n\n<p>The convergence of obesity and diabetes therapeutics with <a href=\"https:\/\/www.delveinsight.com\/report-store\/metabolic-dysfunction-associated-steatohepatitis-mash-market\">MASH treatment<\/a> is a paradigm shift in hepatology. The historical challenge in bringing MASH drugs to market stemmed from the complexity of liver disease progression and fibrosis reversal. However, the latest data from metabolic agents, particularly those achieving significant weight loss, are reshaping expectations. The correlation between \u226510% body weight reduction and fibrosis improvement highlights the metabolic foundation of MASH, reinforcing optimism that therapies originally designed for diabetes and obesity may finally deliver long-awaited solutions for liver disease.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Conclusion_and_Future_Outlook_of_Liver_Disease\"><\/span><strong>Conclusion and Future Outlook of Liver Disease<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The redefinition of liver disease\u2014from NASH to MASH\u2014has transformed therapeutic strategies. By addressing the metabolic underpinnings of liver injury, obesity-targeted pharmacotherapies are emerging as powerful tools in the <a href=\"https:\/\/www.delveinsight.com\/report-store\/liver-fibrosis-market\">fight against liver fibrosis<\/a> and its sequelae. The integration of established agents like semaglutide and tirzepatide with a host of novel GLP\u20111 receptor agonists and dual\/triple agonists alongside FGF21 analogs represents a paradigm shift.<\/p>\n\n\n\n<p>Ultimately, collaboration among pharmaceutical innovators, regulatory bodies, and clinical researchers will be crucial in shaping a more precise, effective, and patient-centered approach to managing one of today\u2019s most pressing global health challenges.\u00a0<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1024\" height=\"194\" src=\"https:\/\/assets.delveinsight.com\/blog\/wp-content\/uploads\/2024\/10\/18173719\/Metabolic-Dysfunction-Associated-Steatohepatitis-Market-Outook-1024x194.png\" alt=\"Metabolic Dysfunction-Associated Steatohepatitis Market Outook\" class=\"wp-image-30116\" srcset=\"https:\/\/assets.delveinsight.com\/blog\/wp-content\/uploads\/2024\/10\/18173719\/Metabolic-Dysfunction-Associated-Steatohepatitis-Market-Outook-1024x194.png 1024w, https:\/\/assets.delveinsight.com\/blog\/wp-content\/uploads\/2024\/10\/18173719\/Metabolic-Dysfunction-Associated-Steatohepatitis-Market-Outook-300x57.png 300w, https:\/\/assets.delveinsight.com\/blog\/wp-content\/uploads\/2024\/10\/18173719\/Metabolic-Dysfunction-Associated-Steatohepatitis-Market-Outook-150x28.png 150w, https:\/\/assets.delveinsight.com\/blog\/wp-content\/uploads\/2024\/10\/18173719\/Metabolic-Dysfunction-Associated-Steatohepatitis-Market-Outook-768x145.png 768w, https:\/\/assets.delveinsight.com\/blog\/wp-content\/uploads\/2024\/10\/18173719\/Metabolic-Dysfunction-Associated-Steatohepatitis-Market-Outook-1536x291.png 1536w, https:\/\/assets.delveinsight.com\/blog\/wp-content\/uploads\/2024\/10\/18173719\/Metabolic-Dysfunction-Associated-Steatohepatitis-Market-Outook.png 1584w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>The paradigm shift from Non\u2010alcoholic Steatohepatitis (NASH) to Metabolic Dysfunction\u2013associated Steatohepatitis (MASH) reflects a deeper understanding of the pathophysiology underpinning liver injury in the context of obesity, diabetes, and metabolic syndrome. This evolving nomenclature from NASH to MASH is more than a semantic update\u2014it mirrors a fundamental change in how we conceptualize liver disease, moving [&hellip;]<\/p>\n","protected":false},"author":14,"featured_media":31477,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_editorskit_title_hidden":false,"_editorskit_reading_time":0,"_editorskit_is_block_options_detached":false,"_editorskit_block_options_position":"{}","advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","footnotes":""},"categories":[17],"tags":[22409,22509,22318,22320,22319,1448,1469,22316,22510,1173],"industry":[17225],"therapeutic_areas":[17240],"class_list":["post-31474","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles","tag-glp-1-receptor","tag-liver-fibrosis","tag-mash","tag-mash-treatment","tag-metabolic-dysfunction-associated-steatohepatitis","tag-nafld","tag-nash","tag-nash-drugs","tag-nash-to-mash","tag-obesity","industry-pharmaceutical","therapeutic_areas-endocrinology-and-metabolic-disorders"],"acf":[],"yoast_head":"<!-- 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