S5 - E20.4 - Drug Development Highlights From EASL Congress 2024: Are FGF-21s Induction Therapy or a "MASH Cure"?

Surfing the MASH Tsunami

Mazen Noureddin and Naim Alkhouri join Jörn Schattenberg and Roger Green to focus on the role FGF-21s will play in long-term advanced fibrosis treatment: induction or long-term therapy...or might we even think of the class as being able to produce a "MASH cure?"
Responding to Naim's comment closing the previous discussion, Mazen questions why we regard FGF-21 agents as induction therapies given that it appears to be as well tolerated as the oral agents and maintains such efficacy over time. In fact, he adds, its sustained efficacy might make it possible for livers to eliminate fibrosis and return to their "normal" state, almost like a "cure."
Jörn adds a comment about pegozafermin, another FGF-21 in development. Jörn notes that this agent is a pegylated molecule, which makes it different from efruxifermin. He notes that NITs show sustained enzyme response at 48 weeks. Mazen reiterates his optimism about the FGF-21 class and reminds us that there is a third FGF-21 in development.
Roger raises Michael Charlton's question (Season 5 Episode 11) whether an induction therapy strategy for FGF-21s might not work if removing the drug allows the MAS activity to return. On the other hand, he notes, it might take years for fibrosis to return. Mazen agrees that many unanswered questions exist, but reiterates his belief in long-term therapeutic value.