Liver decompensation after rapid weight loss from semaglutide in a patient with non-alcoholic steatohepatitis -associated cirrhosis.

2023-12-21

Peverelle, Matthew R

Ng, Jonathan

Peverelle, James

Hirsch, Ryan D

Testro, Adam G

Cirrhosis

Glucagon-like peptide 1 agonists

Non-alcoholic steatohepatitis

Non-alcoholic steatohepatitis cirrhosis

Semaglutide

Weight loss

Journal Article

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10.3748/wjg.v29.i47.6165

There is rapidly increasing uptake of GLP-1 (glucagon-like peptide-1) agonists such as semaglutide worldwide for weight loss and management of non-alcoholic steatohepatitis (NASH). remains a paucity of safety data in the vulnerable NASH cirrhotic population. We report herein the first documented case of liver decompensation and need for liver transplant waitlisting in a patient with NASH-cirrhosis treated with semaglutide. Rapid weight loss led to the development of ascites and hepatic encephalopathy and an increase in the patients Model for Endstage Liver Disease-Na (MELD-Na) score from 11 to 22. Aggressive nutritional supplementation was commenced and the semaglutide was stopped. Over the following months she regained her weight and her liver recompensated and her MELD-Na decreased to 13, allowing her to be delisted from the transplant waitlist. This case serves as a cautionary tale to clinicians using semaglutide in the cirrhotic population and highlights the need for more safety data in this patient group.

link

World Journal of Gastroenterology 2023-12-21; 29(47)

World Journal of Gastroenterology

2219-2840