Semaglutide Weight Outcomes Among Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in a Real-World Setting
Author(s)
Samantha E. Clark, BA, MS, MSc, PhD1, Dominic Nunag, BA1, Matthew Davis, MA1, Arushi Chadha, MS1, Nipun Atreja, MS, PhD2, Blake Thomas, PharmD, MBA2, Francis Lobo, MS, PhD2.
1Medicus Economics, LLC, Milton, MA, USA, 2Madrigal Pharmaceuticals, West Conshohocken, PA, USA.
1Medicus Economics, LLC, Milton, MA, USA, 2Madrigal Pharmaceuticals, West Conshohocken, PA, USA.
OBJECTIVES: As MASLD is often precipitated by overweight/obesity and type 2 diabetes (T2D), many patients are eligible for semaglutide treatment. Although semaglutide trials report high persistence and weight loss, real-world outcomes may differ. We aim to assess weight loss following semaglutide initiation among patients with MASLD.
METHODS: This retrospective cohort study included patients with MASLD who were obese or overweight, starting semaglutide (earliest prescription defined as the index date) from 2017-2024 in Optum Market Clarity data. Patients were required to have ≥1 weight measurement ≤60 days pre- and anytime post-index, with no evidence of other liver diseases or severe MASLD complications during the 12-month baseline period. Patients were grouped into four categories, Group 1: No titration (no semaglutide claim for full maintenance dose) with discontinuation (≥45-day gap in medication coverage); Group 2: No titration with persistence; Group 3: Titration with discontinuation; and Group 4: Titration with persistence. Absolute and percentage weight change at latest measurement within 12 months were assessed.
RESULTS: Of 2,307 patients, 75.3% (n=1,738) had T2D, 62.4% (n=1,440) were female, and mean (standard deviation) age was 53.4 (11.7) years. Mean (SD) baseline weight and BMI were 110.4 (24.8) kg and 38.9 (8.0) kg/m2, respectively, and mean (SD) time to latest follow-up weight measurement was 38.4 (13.5) weeks. Mean (SD) weight loss from baseline was 5.9 (9.8) kg, a 5.2% reduction. 1,269 (55.0%) patients experienced <5% weight loss, while only 193 (8.4%) achieved ≥15% weight loss. Groups 1, 2, 3, and 4 comprised 46.6%, 41.4%, 3.9%, and 8.5% of the sample, with mean (kg) (percentage) weight loss of 4.6 (4.0%), 5.8 (5.1%), 10.3 (9.0%), and 11.9 (10.4%), respectively.
CONCLUSIONS: Findings suggest lack of alignment between semaglutide trial results and real-world outcomes in a MASLD population. Most patients did not titrate or discontinued medication, both of which were associated with limited weight reduction benefits.
METHODS: This retrospective cohort study included patients with MASLD who were obese or overweight, starting semaglutide (earliest prescription defined as the index date) from 2017-2024 in Optum Market Clarity data. Patients were required to have ≥1 weight measurement ≤60 days pre- and anytime post-index, with no evidence of other liver diseases or severe MASLD complications during the 12-month baseline period. Patients were grouped into four categories, Group 1: No titration (no semaglutide claim for full maintenance dose) with discontinuation (≥45-day gap in medication coverage); Group 2: No titration with persistence; Group 3: Titration with discontinuation; and Group 4: Titration with persistence. Absolute and percentage weight change at latest measurement within 12 months were assessed.
RESULTS: Of 2,307 patients, 75.3% (n=1,738) had T2D, 62.4% (n=1,440) were female, and mean (standard deviation) age was 53.4 (11.7) years. Mean (SD) baseline weight and BMI were 110.4 (24.8) kg and 38.9 (8.0) kg/m2, respectively, and mean (SD) time to latest follow-up weight measurement was 38.4 (13.5) weeks. Mean (SD) weight loss from baseline was 5.9 (9.8) kg, a 5.2% reduction. 1,269 (55.0%) patients experienced <5% weight loss, while only 193 (8.4%) achieved ≥15% weight loss. Groups 1, 2, 3, and 4 comprised 46.6%, 41.4%, 3.9%, and 8.5% of the sample, with mean (kg) (percentage) weight loss of 4.6 (4.0%), 5.8 (5.1%), 10.3 (9.0%), and 11.9 (10.4%), respectively.
CONCLUSIONS: Findings suggest lack of alignment between semaglutide trial results and real-world outcomes in a MASLD population. Most patients did not titrate or discontinued medication, both of which were associated with limited weight reduction benefits.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO218
Topic
Clinical Outcomes, Patient-Centered Research, Study Approaches
Topic Subcategory
Clinical Outcomes Assessment
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas