US Healthcare Professionals’ Management of MASH and Knowledge of GLP-1, GIP, and Glucagon Receptor Agonists

INTRODUCTION: Various combinations of agonists of the glucagon-like peptide-1 receptor (GLP-1R), glucose-dependent insulinotropic polypeptide receptor (GIPR), and glucagon receptor (GCGR) are in clinical trials for the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH). We explored how US healthcare professionals (HCPs) treating people with MASLD/MASH perceive these investigational agents. METHODS: Respondents to this online survey (November 2024 to January 2025) were specialists in hepatology/gastroenterology (HEP/GASTROs), endocrinology (ENDOs), and primary care (PCCs). The survey assessed awareness of GLP-1R, GIPR, and GCGR pathways, as well as pharmacotherapeutics targeting them. RESULTS: Of 760 respondents, 256 were HEP/GASTROs, 252 were ENDOs, and 252 were PCCs. Ultrasound was the most common imaging technique used to diagnose and assess MASH overall (69.8%); however, HEP/GASTROs most commonly used vibration-controlled transient elastography (71.9%). Only 53.9% and 30.1% of HCPs were “very” or “extremely familiar” with GIPR and GCGR, respectively, but most (76.8%) HCPs were “very” or “extremely familiar” with GLP-1R. ENDOs were more likely than either HEP/GASTROs or PCCs to state that activation of GCGR was associated with increased glycogenolysis and gluconeogenesis (59.7% vs 50.0% [ P < 0.05] vs 50.2% [ P < 0.05]). A total of 90.3%, 75.9%, and 87.0% of respondents expected GLP-1R, GIPR, and GCGR agonists, respectively, to benefit people with MASH. CONCLUSIONS: HCPs were generally more familiar with GLP-1R, and the effects of its activation, than with GIPR and GCGR. HCPs anticipate that agonists of these receptors will have meaningful clinical benefits for MASLD/MASH and other cardiometabolic conditions.