Perspective reviews emerging antifibrotic therapies for metabolic dysfunction-associated steatohepatitis

This perspective article discusses the landscape of emerging antifibrotic therapies for metabolic dysfunction-associated steatohepatitis (MASH), liver fibrosis, and cirrhosis. It reviews two broad categories: indirect-acting metabolic agents, such as glucagon-like peptide 1 (GLP-1) analogues, and direct-acting therapies, including thyroid hormone receptor beta (THRβ) activators and fibroblast growth factor 21 (FGF21) analogues. The article frames this discussion against a historical backdrop of largely failed past efforts to develop antifibrotic drugs, suggesting recent advances in MASH metabolic therapies may offer new hope.

No specific study design, population, sample size, setting, comparator, or follow-up duration is reported, as this is not a primary research article. Similarly, no primary or secondary outcomes, main results, effect sizes, or statistical measures are provided. The article does not present data from a specific clinical trial.

Safety and tolerability information for the discussed therapies is not reported. The article's key limitation is its nature as a perspective piece summarizing emerging concepts rather than reporting empirical evidence from a defined clinical study. Therefore, its practice relevance is restrained; it serves to outline a therapeutic landscape for consideration but does not provide evidence to guide specific clinical decisions. The findings should be interpreted as a narrative review of potential future directions, not as established clinical evidence.