What is the new medication for liver scarring? An overview of recent advances

October 9, 2025 •

3 min read

According to the FDA, approximately 6% of U.S. adults are affected by MASH, a serious liver disease that can lead to scarring (fibrosis). Recently, major advances have answered the question: What is the new medication for liver scarring? by bringing the first-ever medications specifically for this condition to market, offering new hope for treatment.

Quick Summary

This article discusses the new FDA-approved medications for liver fibrosis associated with MASH, including Rezdiffra and Wegovy. It also explores investigational treatments and the importance of lifestyle interventions in managing liver scarring.

Key Points

Rezdiffra is the first oral medication approved for treating MASH with moderate to advanced fibrosis, acting as a thyroid hormone receptor-beta agonist to reduce liver fat.
Semaglutide (Wegovy) has been approved for MASH with moderate to advanced fibrosis, leveraging its GLP-1 receptor agonist mechanism to improve liver histology and promote weight loss.
Both Rezdiffra and Wegovy are used alongside lifestyle changes including diet and exercise, which remain a cornerstone of effective MASH management.
Investigational cell therapies are being explored in trials like EMERALD and MATCH, using engineered macrophages to potentially reverse liver damage in advanced cirrhosis.
A range of other drug candidates like Efruxifermin, Pegozafermin, and Lanifibranor are in various stages of clinical trials for liver fibrosis.
New treatments focus on addressing the underlying causes of MASH to prevent further damage and, in some cases, reverse existing scarring.

For decades, the primary management for liver scarring, or fibrosis, was limited to addressing the underlying cause and promoting healthy habits. However, recent breakthroughs have introduced the first medications specifically targeted at treating liver fibrosis resulting from metabolic dysfunction-associated steatohepatitis (MASH), formerly known as non-alcoholic steatohepatitis (NASH). These new pharmacological options represent a significant step forward in treating a condition that previously had no specific drug therapy.

Rezdiffra (resmetirom): The First of Its Kind

In March 2024, the U.S. Food and Drug Administration (FDA) granted accelerated approval to Rezdiffra (resmetirom). This daily oral medication is the first approved to treat MASH with moderate to advanced liver fibrosis, but not cirrhosis. Rezdiffra is a thyroid hormone receptor-beta (THR-β) agonist that is selectively active in the liver. By activating this receptor, it helps reduce liver fat accumulation, a key contributor to MASH inflammation and scarring. Its approval was based on a Phase 3 trial showing significant MASH resolution and fibrosis improvement after 12 months. Rezdiffra should be used with a healthy diet and exercise. Common side effects include diarrhea and nausea. It is not recommended for patients with decompensated cirrhosis.

Wegovy (semaglutide): A GLP-1 Agonist for MASH

Following its use for obesity and diabetes, the FDA approved Wegovy (semaglutide) in August 2025 for treating MASH in adults with moderate-to-advanced fibrosis. As a GLP-1 receptor agonist, semaglutide primarily regulates appetite and blood sugar, leading to weight loss, which benefits MASH. It also appears to have a direct effect on liver inflammation and fat. Approval was based on a Phase 3 trial where, at 72 weeks, a significant percentage of participants on Wegovy achieved MASH resolution and no worsening of fibrosis, along with weight loss and improved cardiometabolic factors.

Investigational Therapies for Liver Scarring

Beyond approved medications, research into new therapies for liver fibrosis, especially for advanced cirrhosis, is ongoing.

Cell Therapy

Studies are exploring cell therapies for advanced liver cirrhosis. Trials are investigating engineered macrophages—immune cells modified to target and break down scar tissue in the liver. This offers potential hope for patients with decompensated cirrhosis, aiming to return the liver to a stable state.

Other Drug Candidates

Several other drugs are in clinical trials for liver fibrosis. These include Pegozafermin and Lanifibranor in Phase 3 trials for MASH with fibrosis, and Belapectin, a galectin-3 antagonist, in Phase 3 trials for NASH cirrhosis.

Lifestyle Interventions: The Foundation of Treatment

New medications are used alongside lifestyle changes, which are fundamental to MASH treatment. Weight management, diet, and exercise can halt or reverse early liver damage. Key strategies include maintaining a healthy weight, eating a balanced diet, limiting alcohol, avoiding excessive sugar and saturated fats, and consuming fiber and omega-3 fatty acids.

Comparison of Key Approved Treatments


Feature	Rezdiffra (resmetirom)	Wegovy (semaglutide)
Mechanism	Thyroid hormone receptor-beta (THR-β) agonist	Glucagon-like peptide-1 (GLP-1) receptor agonist
Indication	MASH with moderate to advanced fibrosis (F2-F3), non-cirrhotic	MASH with moderate to advanced fibrosis (F2-F3)
Approval Date	March 2024 (accelerated approval)	August 2025 (accelerated approval)
Trial Outcomes	Significant MASH resolution & fibrosis improvement reported at 12 months	Significant MASH resolution & fibrosis improvement reported at 72 weeks
Route of Administration	Daily oral tablet	Once-weekly subcutaneous injection
Common Side Effects	Diarrhea, nausea, pruritus (itching)	Nausea, diarrhea, vomiting, constipation, abdominal pain
Requires Lifestyle Intervention	Yes, prescribed with diet and exercise	Yes, prescribed with diet and exercise

Conclusion

The FDA approvals of Rezdiffra and Wegovy mark a new era in treating liver scarring from MASH, providing specific pharmacological options that complement essential lifestyle changes. These medications significantly improve liver histology, while ongoing research into other drugs and cell therapies offers hope for more advanced stages. As new treatments emerge, the outlook for patients is increasingly promising. It is vital for patients to work with their medical team to create a comprehensive treatment plan that addresses the root causes of their condition.

Frequently Asked Questions

Rezdiffra (resmetirom) is the first medication approved by the FDA for treating metabolic dysfunction-associated steatohepatitis (MASH) in adults who have moderate to advanced liver fibrosis but not cirrhosis.

Semaglutide, known commercially as Wegovy, was approved by the FDA in August 2025 to treat MASH in adults with moderate to advanced liver fibrosis.

Rezdiffra is a thyroid hormone receptor-beta (THR-β) agonist that activates a receptor in the liver, which helps to reduce the accumulation of fat in the organ. This addresses the metabolic issue driving the inflammation and scarring associated with MASH.

These medications are approved for use before cirrhosis has developed. While they show promise in reducing and stabilizing fibrosis, treatment for advanced cirrhosis often involves managing complications or considering a liver transplant.

Yes, both Rezdiffra and Wegovy are intended for use alongside lifestyle changes, such as a healthy diet and exercise. These foundational habits are still crucial for managing liver disease effectively.

For Rezdiffra, common side effects include diarrhea and nausea. For Wegovy, common side effects are also gastrointestinal and include nausea, diarrhea, constipation, and vomiting.

MASH, or metabolic dysfunction-associated steatohepatitis, is the new name for what was previously known as NASH (non-alcoholic steatohepatitis). The name was changed to better reflect the condition's connection to metabolic disorders.