Pegozafermin for NASH — A Sprint to Start a Marathon

This editorial discusses the challenges and progress in pharmacotherapy for nonalcoholic steatohepatitis (NASH), focusing on the fibroblast growth factor 21 (FGF21) analogue pegozafermin. The author highlights the complexities of NASH treatment, including variable disease progression and the limitations of histologic endpoints. Results from a phase 2b trial show promising reductions in fibrosis and NASH resolution with pegozafermin, though durability and immunogenicity concerns remain. The editorial underscores the need for long-term efficacy data and the potential role of noninvasive biomarkers in future clinical assessments.

This editorial discusses the challenges and progress in pharmacotherapy for nonalcoholic steatohepatitis (NASH), focusing on the fibroblast growth factor 21 (FGF21) analogue pegozafermin. The author highlights the complexities of NASH treatment, including variable disease progression and the limitations of histologic endpoints. Results from a phase 2b trial show promising reductions in fibrosis and NASH resolution with pegozafermin, though durability and immunogenicity concerns remain. The editorial underscores the need for long-term efficacy data and the potential role of noninvasive biomarkers in future clinical assessments.