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

Yestle Kim,1 Ni Zeng,2 Jessamine P Winer-Jones,2 Machaon Bonafede,2 Francis Lobo,1 John O’Donnell,1 Taylor Ryan2 1Health Economics and Outcomes Research Madrigal Pharmaceuticals, Inc, West Conshohocken, PA, USA; 2Real World Evidence, Veradigm, Chicago, IL, USACorrespondence: Yestle Kim, Health Economics and Outcomes Research, Madrigal Pharmaceuticals, West Conshohocken, PA, USA, Email [email protected]: 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.Keywords: metabolic dysfunction-associated steatohepatitis, non-alcoholic steatohepatitis, metabolic dysfunction–associated fatty liver disease, semaglutide, GLP-1 receptor agonist