Your liver health matters. If your doctor has diagnosed you with a fatty liver condition, several different treatments may help. These conditions include metabolic-associated steatotic liver disease (MASLD) or its more serious form, metabolic dysfunction-associated steatohepatitis (MASH). You may have heard these conditions called NAFLD and NASH in the past. In 2023, the names were changed to better reflect the role of metabolic dysfunction in developing these liver diseases.
The medications semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) were developed to manage type 2 diabetes and obesity. Now, research shows that by helping to treat these conditions, these drugs can also be an important tool for people looking to help control and manage MASLD/MASH. One medication, Wegovy, has been approved for the treatment of MASH. The FDA hasn’t yet approved Ozempic, Mounjaro, or Zepbound specifically to target MASLD or MASH. However, your doctor can prescribe them for this purpose. This is called off-label use.
These treatments are important for the Hispanic community, who as a group have higher risks of developing these conditions. But while Hispanic people often need these newer treatments the most, research shows that they may also face challenges in getting them.
MASLD and MASH: Higher Risks in the Hispanic Community
If you’re Hispanic, your risk of MASLD is about 50% higher than non-Hispanic adults. About 4 in 10 Hispanic adults in the United States have MASLD, while it affects about 1 in 4 adults overall.
And if you develop MASLD, you also face greater chances of more serious liver problems. MASLD can progress more quickly in Hispanic people compared to other groups. Hispanic people have about a 42% higher chance than non-Hispanic people of developing MASH and about a 37% higher chance of advanced liver scarring.
Research shows several key influences that make these diseases more common for Hispanic people:
Genes. Your genes can affect how your body processes fat. Studies have shown that this can affect many Hispanic people, but it’s more common among people of Mexican descent. These differences can make you more likely to store fat and develop MASLD and MASH.
Diet and activity. Many Hispanic adults eat a diet with high levels of saturated fats and sugars and not enough fruits and vegetables. They also tend to get less exercise. Together, these things can increase your chance of obesity and chronic diseases. Obesity is the biggest risk factor for MASLD and MASH.
Type 2 diabetes. Hispanic people have this condition at a higher rate than the national average. It has a strong link to MASLD and MASH, especially when combined with obesity.
Promising New Treatments for MASH
If you have MASH, there's ongoing research on how other new drugs may help.
Semaglutide (Ozempic, Wegovy)
Your body makes a natural hormone called GLP-1 (glucagon-like peptide-1). It helps control your blood sugar and cuts down on how hungry you feel. Drugs like Ozempic and Wegovy contain semaglutide, which works like this hormone to control your blood sugar and hunger signals.
Semaglutide can affect several aspects of your health. It:
- Controls blood sugar levels
- Reduces hunger and appetite
- Improves blood pressure and cholesterol
A recent clinical trial reveals that semaglutide helps your liver in two ways: It reduces inflammation happening now and helps repair scarring from past damage. The study found that 62.9% of people who took semaglutide showed significant improvement in overall liver health. And 37% of people taking semaglutide had less liver scarring.
Also important, this group lost about 10.5% of their body weight. Even a small amount of weight loss – as little as 5% to 10% – can reduce fat buildup in your liver. Less liver fat means less inflammation, a positive cycle that helps your liver get healthier.
Tirzepatide (Mounjaro)
This is another medication that helps heal your liver in two ways. It’s available as Mounjaro for diabetes treatment and Zepbound for weight loss.
Tirzepatide is unique because it works with two of your body's natural hormones. Like semaglutide, it acts on GLP-1. It also affects a hormone called glucose-dependent insulinotropic polypeptide, or GIP. GIP plays a role in weight loss by helping send signals to your brain when you eat to tell it when you feel full.
Tirzepatide can affect several aspects of weight loss and liver health:
- Helps with blood sugar control
- Reduces hunger and appetite
- Improves blood pressure and cholesterol
In a clinical trial, between 56% and 62% of people taking tirzepatide saw an improvement in overall liver health. Just over half (51%) had reduced liver scarring.
These findings suggest that tirzepatide could help people with MASH when combined with healthy lifestyle changes, including a healthy diet and exercise.
Possible Barriers to Newer Medications for Hispanic Patients
With greater odds of having MASLD or MASH, people in the Hispanic community have a clear need for these newer medications. But research has shown that being part of this group can affect how likely you are to use and be able to get them. Hispanic people face many barriers to getting medications. High out-of-pocket costs, limited insurance coverage, lack of access to specialists, cultural and language barriers, and higher levels of distrust in the healthcare system can affect care and treatment choices.
The reasons for these gaps aren’t fully understood. But research has consistently pointed to several other factors that may make it harder for some to get these medications:
High out-of-pocket costs. These drugs often pose significant cost barriers, even with insurance coverage. High monthly copayments may lead to people not filling prescriptions even when they’re able to get them. High costs can also lead to the use of cheaper alternative drugs that may not be as effective.
Limited insurance coverage. Hispanic people are more than twice as likely as non-Hispanic White people to be uninsured. Without insurance coverage, the high monthly costs of these medications may be out of reach for many people.
Access to specialists. Some newer medications require visits to specialists. You might not even learn about these treatment options if you can't get to see the right doctor. If you have to travel too far to get to an appointment or your insurance doesn’t cover it, this type of care can be out of reach.
Cultural barriers. Research shows doctors can have unconscious biases that may make them less likely to offer certain medications to Hispanic patients. In turn, some Hispanic people of certain backgrounds may pass on seeing a doctor because of a strong belief in natural remedies or faith as ways to stay healthy or treat illness.
Language barriers. More than half of Hispanic people report having difficulty communicating with a health care provider because of a language barrier. Research shows that these barriers can lead to a worse quality of care: People may miss out on vital screenings or not get important vaccinations.
Distrust in the health care system. Hispanic adults have reported higher levels of mistrust in the medical system when compared to White adults. This distrust can be due to experiences of discrimination over income, insurance, race, ethnicity, and language barriers. It can affect the quality of care when a person is less likely to share information or stay with their treatment plan.
Are These Newer Drugs Right for You?
Your doctor can help you decide whether these newer drugs might be a good fit for you. Both semaglutide and tirzepatide have shown promising results for liver health, but everyone's needs differ. Your doctor should know your whole health picture. Other health conditions you may have and medicines you take will play a role too.
The best treatment plan will match your specific needs. Your doctor should examine your test results, health history, and goals. They can explain the benefits and risks of each medicine in a way that makes sense for your situation. Be sure to share any concerns you have with them and don’t be afraid to ask questions.
Recap
- If you have MASLD/MASH, new medications like semaglutide and tirzepatide can help treat it.
- They work by improving liver health, controlling blood sugar, and promoting weight loss.
- Hispanic people are at higher risk for these conditions and may face challenges accessing treatments.
- Barriers to treatment may include high costs, limited insurance, and language barriers.
- Talk to your doctor about the best treatment plan for you, considering your health needs and any barriers you may face in getting the care you need.
Show Sources
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