Retrospective Study of Real-World Treatment Patterns of Subcutaneous Semaglutide Use Among Patients with Metabolic Dysfunction-Associated Steatohepatitis in the United States.

BACKGROUND

Interim results from the ESSENCE clinical trials indicate that 72-week treatment with high-dose subcutaneous (SC) semaglutide may result in metabolic dysfunction-associated steatohepatitis (MASH) resolution and improvements in fibrosis. As some patients with MASH have been prescribed SC semaglutide for the treatment of comorbid type 2 diabetes and/or obesity, this study assessed real-world 72-week treatment patterns among patients with MASH.

METHODS

In a linked electronic health records (Veradigm Network EHR) and claims (Komodo Health) dataset, adults (≥18 years old) with a MASH diagnosis, who initiated treatment with SC semaglutide between 7/1/2018 and 6/30/2023, were identified. Other causes of liver disease (eg, viral hepatitis) or severe complications (eg, cirrhosis) were excluded. The study period included ≥52 weeks before and ≥72 weeks after the first SC semaglutide claim. A subgroup analysis was conducted among those who received the brand approved for 2.4 mg/week dosage (SC semaglutide 2.4) and among people at risk for MASH. Patient characteristics and treatment patterns are reported.

RESULTS

This study identified 6,537 patients with MASH, who initiated treatment with SC semaglutide, 358 of whom received only the brand approved for 2.4 mg/week dosage. Patients were ~50 years old, and a majority were female. Non-persistence occurred in 68.4% of the overall SC semaglutide cohort and 78.5% of the SC semaglutide 2.4 subgroup. The mean time to non-persistence was 24.8 (19.3) and 20.1 (16.9) weeks in the SC semaglutide and SC semaglutide 2.4 groups, respectively. In the SC semaglutide 2.4 subgroup, 182 patients (50.8%) reached the recommended dosage of 2.4 mg/week, and 28 (7.8%) reached the recommended dosage within the first 16 weeks and sustained that dosage for ≥56 weeks. Trends were similar among patients at risk for MASH.

CONCLUSION

In a real-world setting, very few patients achieved the treatment regimen associated with MASH resolution and improvements in fibrosis.