Novo Nordisk’s blockbuster obesity drug Wegovy is set to be greeted by physician enthusiasm and "swift" adoption as it taps into a new liver disease market in the U.S. with a recent nod in metabolic dysfunction-associated steatohepatitis (MASH), according to Spherix Global Insights.
Wegovy is only the second drug approved in the condition, which is characterized by excess fat in the liver that causes chronic inflammation. Madrigal Pharmaceuticals’ Rezdiffra earned its landmark approval in the disease last March and has since built a strong adoption base with continued robust momentum, Spherix found in a separate series of studies.
Still, there’s room—and excitement—for Novo’s offering in the growing MASH market. While only 42% of gastroenterologists and hepatologists reported awareness of Wegovy’s new approval when surveyed one week after the Aug. 18 nod, nearly two-thirds (65%) of the physicians told Spherix they expect to prescribe it within the next three months.
Wegovy, a GLP-1 med, eases MASH by reducing fat levels in the liver, while thyroid receptor-beta agonist Rezdiffra targets the liver directly. Both are specifically indicated for adults with MASH who have moderate to advanced fibrosis but not cirrhosis of the liver, to be used alongside a reduced-calorie diet and exercise.
The doctors suggested the two drugs’ differing approaches could be favorable to different patient profiles. For patients with moderate fibrosis, or an F2 score of liver fibrosis, Wegovy took the lead as the preferred treatment, with 43% of physicians citing the drug’s weight loss benefits as a key driver of improvements in liver fat, fibrosis and metabolic health overall.
Meanwhile, nearly a third of doctors surveyed sided with Rezdiffra for patients with moderate fibrosis based on its proven antifibrotic efficacy.
A union of both options may be the route to go for patients with advanced fibrosis (F3), as suggested by the 43% of physicians who doubted the ability of monotherapy alone in the high-risk population.
“We have known for several years that monotherapy is less likely to be the final answer for advanced MASH liver disease,” Spherix quoted one specialist as saying. “The combination of Rezdiffra and Wegovy offers the possibility of preventing that progression, at least until we have more effective monotherapy.”
While both Wegovy and Rezdiffra seem to have ample elbow room in the current market, other competitors are looming. Novo’s GLP-1 rival Eli Lilly, for one, posted positive data on its tirzepatide in MASH last June.
Madrigal collected $212.8 million in Rezdiffra sales over the second quarter, before Wegovy’s approval came in.