Malaga doctors find in Ozempic ally against fatty liver disease

Doctors primarily prescribe semaglutide, known by its brand names Ozempic and Wegovy, to treat diabetes, hypertension or dyslipidemia (excess fats in the blood such as high cholesterol or triglycerides). It is also effective in helping patients lose weight when they have a body mass index (BMI) over 30.

Ozempic has now also become an unexpected ally for hepatologists in the fight against the "silent epidemic" of fatty liver disease - a condition that, according to head of the digestive system unit at the El Clínico hospital in Malaga Dr Andrade, affects between 30 and 40 per cent of the population in Malaga province.

"Semaglutide, a GLP-1 analogue, is very well-known. Some people buy it at the pharmacy to lose weight. This drug has also shown efficacy in improving fatty liver," Dr Andrade says. "I expect that it will soon be available for this condition too," he states.

Ozempic helps the liver by acting as a metabolic "cleanser": it improves diabetes control and reduces the patient's weight, which then prevents the body from sending excess fat to the liver and forces it to use its existing fat reserves. This process resolves steatohepatitis, meaning the liver is no longer inflamed and "flooded" with fat, allowing the organ to recover its normal function before the damage becomes irreversible. It helps slow the progression of fatty liver disease and, in some cases, even reverses it.

Dr Andrade also mentions another drug that has shown efficacy against fatty liver disease in research: Resmetirom (the active ingredient), not yet available in Spain, but already approved by European health authorities. "These medications have shown great effectiveness in slowing the disease and even reversing fibrosis (scarring of the liver) in patients with metabolic fatty liver disease."

Dr Andrade believes that fatty liver "is a pandemic right now". He warns that this "metabolic disorders that cause fat to be deposited in the liver" can eventually "evolve into cirrhosis" if not diagnosed early."Furthermore, it is very silent until it develops and decompensation occurs."

According to Dr Andrade, not all cases of fatty liver "will progress to cirrhosis, but some will". "There is a major pandemic underway and we are already beginning to see the consequences: the worst is yet to come," he says.

Nowadays, doctors can enter the values from a simple blood test, such as platelets or transaminases, into a calculator along with other parameters like age, which allows for a diagnosis of fatty liver or fibrosis. "Some people have elevated transaminase levels, that is, tests indicating liver inflammation, but they may not yet have fibrosis. Others, however, may have almost normal transaminase levels and yet already have fibrosis because they have had the disease for longer," Dr Andrade says.

Detecting fibrosis in the early stages of the disease is proving essential. According to the head of the digestive system unit, doctors in primary care can also use calculators available online.

The recommendation is that general practitioners closely monitor liver scarring, but, for this to happen, they need to be "involved in the protocols" hospital experts develop.

"By diagnosing early, we can intensify measures that, at the moment, are mainly lifestyle-related: losing weight, improving diet, controlling diabetes, exercising and avoiding alcohol. At the same time, there are medications that could be used to prevent the progression of the disease," Dr Andrade states.

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