S2798 Familiarity With Glucagon, GLP-1, and GIP Receptor Agonists and Dual Agonists Among Hepatology/Gastroenterology, Primary Care, and Endocrinology Specialists

Introduction: Ongoing clinical trials are evaluating mono, dual, and triple agonists of the glucagon receptor (GCGR), glucose-dependent insulinotropic polypeptide receptor (GIPR), and glucagon-like peptide-1 receptor (GLP-1R) for the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH). We compared the perception of these mechanisms of action (MOA) among hepatologists/gastroenterologists (HEP/GASTRO), endocrinologists (ENDO), and primary care physicians (PCP) treating people with MASLD/MASH, including advanced practice providers within each specialty, to identify potential knowledge gaps. Methods: From November 2024 to January 2025, an online survey was completed by US clinicians treating people with MASLD/MASH to assess their knowledge of GCGR, GLP-1R and GIPR agonists. Results: A total of 760 clinicians responded: HEP/GASTRO (n = 256), ENDO (n = 252), PCP (n = 252), managing an average of 23, 18, and 15 patients per week with MASLD/MASH, respectively. Ultrasound imaging was commonly used to diagnose MASH across specialty, but less so by HEP/GASTRO (67.2%) or ENDO (62.8%) than PCP (79.4%, P < 0.01), while vibration-controlled transient elastography was more commonly used by HEP/GASTRO (71.9%, P < 0.01) than ENDO (43.6%) or PCP (34.9%). For biomarker tests, liver enzymes were commonly used across specialty (HEP/GASTRO 76.2%; ENDO 81.7%; PCP 81.3%), but FIB-4 was more commonly used by HEP/GASTRO (72.7%, P < 0.01) than ENDO (56.7%) or PCP (37.7%). Fewer HEP/GASTRO (66.0%) and PCP (67.1%) were “very” or “extremely familiar” with GLP-1R than ENDO (97.6%). Fewer specialists were “very” or “extremely familiar” with GCGR (HEP/GASTRO 25.4%, ENDO 49.2%, PCP 15.9%) and GIPR (HEP/GASTRO 37.1%, ENDO 86.5%, PCP 38.5%). All specialties were less familiar with the effects of activation of GCGR and GIPR than GLP-1R. All specialties expected GCGR, GIPR, and GLP-1R agonists to benefit people with cardiometabolic (CM) conditions including MASH. Fewer HEP/GASTRO than ENDO and PCP expected dual GCGR/GLP-1R agonists to be better than GLP-1R mono-agonists for control of hypertension, dyslipidemia, and type 2 diabetes. Conclusion: All specialists were more familiar with GLP-1R than with GCGR and GIPR. HEP/GASTRO and PCP were less familiar with GLP-1R, GCGR, and GIPR than ENDO, highlighting potential opportunities for education as these MOA become available. Specialists anticipate that dual GCGR/GLP-1R agonists will benefit the treatment of MASLD/MASH and other CM conditions.