Exploration of Medicine

Table 2. Heterogeneity of drugs in MASH treatment.

Drug name and chemical structure	Drug class	Mechanism of action	Reference
Resmetirom	Liver-selective THR agonist	Counteracts intrahepatic hypothyroidism in MASH by reducing LFC, liver enzymes, hepatic fibrogenesis, and LDL-Chol.	Lonardo, 2024 [20]
Semaglutide	GLP-1 RA	Reduces IR by lowering total body weight and visceral adiposity, blood pressure, CRP levels, and improving lipid profiles.	Weiskirchen and Lonardo, 2025 [21]
Tirzepatide	Dual GIP/GLP-1 RA	Improves glycemic homeostasis and promotes weight loss.	Lonardo and Weiskirchen, 2025 [22]
Denifanstat	FASN inhibitor	Blocks DNL, a key step in MASH pathogenesis.	Loomba et al., 2024 [17]
Dapagliflozin	SGLT2 inhibitor	Modulates energy homeostasis, reduces IR, and exhibits anti-inflammatory, antioxidant, and anti-fibrotic effects.	Lin et al., 2025 [18]
Efruxifermin	FGF21 analogue	Exerts antifibrotic activity, reduces liver steatosis, IR, and dyslipidemia.	Harrison et al., 2024 [23]

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CRP: C-reactive protein; DNL: de novo lipogenesis; FASN: fatty acid synthase; FGF: fibroblast growth factor; GIP: gastrointestinal peptide; GLP-1 RA: glucagon-like peptide-1 receptor agonist; IR: insulin resistance; LDL-Chol: low-density lipoprotein cholesterol; LFC: liver fat content; MASH: metabolic dysfunction-associated steatohepatitis; RA: receptor agonist; SGLT2: sodium-glucose cotransporter 2; THR: thyroid hormone.

Declarations

Acknowledgments

The authors thank Sabine Weiskirchen (IFMPEGKC) for her help in drawing the figures for this manuscript.

Author contributions

AL and RW: Conceptualization, Investigation, Writing—original draft, Writing—review & editing. Both authors read and approved the submitted version.

Conflicts of interest

Amedeo Lonardo, who is the Associate Editor of Exploration of Medicine, and Ralf Weiskirchen, who is the Editorial Board Member of Exploration of Medicine, both had no involvement in the decision-making or the review process of this manuscript.

Ethical approval

Not applicable.

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