Evidence synthesis · §4
Incretin receptor agonists for metabolic dysfunction-associated steatohepatitis — summary of findings
Outcome-by-outcome summary with effect, certainty and the reason for each downgrade.
§4Summary of findings
§4.1Summary of findings
Table 7. Summary of findings for Incretin receptor agonists for metabolic dysfunction-associated steatohepatitis.
| Outcome | Participants (studies) | Effect as reported | Certainty | Reason for downgrade |
|---|---|---|---|---|
| Resolution of steatohepatitis without worsening of fibrosisThe outcome the Institute designates as anchor for this indication. | 1,682 (3) | Moderate certainty evidence indicates that incretin receptor agonists produce resolution of steatohepatitis without worsening of fibrosis… | Moderate | publication bias |
| Discontinuation for adverse eventsReported as a summary-of-findings row rather than in a tolerability annex, following a public submission. | 1,251 (1) | Reported per contributing trial; see the included-studies table | Moderate | risk of bias |
| Serious adverse eventsEvent counts are low; the estimate is imprecise by construction. | 1,588 (1) | Reported per contributing trial; see the included-studies table | Low | risk of bias, imprecision |
| Any adverse eventAscertained by spontaneous report in the contributing trials. | 1,286 (1) | Reported per contributing trial; see the included-studies table | Low | inconsistency, indirectness |
| Improvement of fibrosis by ≥1 stage without worsening of steatohepatitisA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it. | 1,026 (2) | Reported as a secondary outcome in a subset of contributing trials | Low | risk of bias, imprecision |
| Change in liver stiffness by vibration-controlled transient elastographyA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it. | 1,126 (2) | Reported as a secondary outcome in a subset of contributing trials | Low | inconsistency, publication bias |
| Certainty ratings describe confidence in the effect estimate for the stated outcome. They are not recommendations and do not transfer between outcomes. | ||||
§4.2Forest plot
Study estimatePooled estimate
§4.3Certainty assessment for the anchor outcome
Table 8. Reasoning recorded against each certainty domain for the anchor outcome.
| Domain | Rating | Reasoning |
|---|---|---|
| Risk of bias | No concern | No serious concern identified in this domain. |
| Inconsistency | No concern | No serious concern identified in this domain. |
| Indirectness | No concern | No serious concern identified in this domain. |
| Imprecision | No concern | No serious concern identified in this domain. |
| Publication bias | Serious | Too few contributing studies for a formal assessment; the risk cannot be excluded. |
| Overall: Moderate certainty. The true effect is likely to be close to the estimate, but there is a possibility that it is substantially different. Further research is likely to have an important impact on confidence in the estimate. | ||
References cited on this page
References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.
- Sanyal AJ, Newsome PN, Kliers I, Østergaard LH, Long MT, Kjær MS, Cali AMG, Bugianesi E, Rinella ME, Roden M, Ratziu V. Phase 3 trial of semaglutide in metabolic dysfunction-associated steatohepatitis. New England Journal of Medicine 2025;392(21):2089–2099. doi:10.1056/NEJMoa2413258
Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.
Compound Evidence Institute · CEI-ES-010/4 · https://compoundevidence.com/syntheses/mash-histological-endpoints/summary-of-findings/ · retrieved 30 July 2026