Spherix Global Insights Finds One-Third of Treated MASH Patients Remain Inadequately Controlled Even as Prescription Use Expands

Physicians favor longer trials and therapy augmentation, while tailored combination use signals greater complexity once new options enter the market.

Exton, PA, Aug. 20, 2026 (GLOBE NEWSWIRE) -- The treatment landscape for metabolic dysfunction-associated steatohepatitis (MASH) is expanding as prescription therapy becomes integrated into routine patient management. Despite this progress, substantial unmet needs persist, with many treated patients experiencing suboptimal outcomes or requiring a treatment change, raising questions about how physicians will manage inadequate response as the therapeutic landscape expands.

According to Spherix Global Insights’ Patient Chart Dynamix™: MASH (US) 2026, specialists report that approximately one-third of MASH patients taking prescription therapy are achieving suboptimal results or require a treatment change which highlights an emerging pool of patients for whom dose adjustments, augmentation, or eventually switching may become increasingly important. The findings are based on a survey and analysis of data sourced from 647 MASH patient charts submitted by 119 gastroenterologists and 23 hepatologists.

Prescription therapy has become standard practice for most diagnosed MASH patients. Gastroenterologists estimate that 71% of their MASH patients require prescription therapy in addition to lifestyle modification, while hepatologists place the proportion at 74%. Approximately three-quarters of audited patients are receiving pharmacologic treatment specifically for MASH, including Madrigal Pharmaceuticals’ Rezdiffra® (resmetirom), Novo Nordisk’s Wegovy® (semaglutide) or another prescription therapy.

Non-invasive testing now anchors the diagnostic pathway, with FibroScan widely used and highly rated across both specialties. However, patient identification continues to depend heavily on abnormal blood work, metabolic risk factors, and primary care referrals. Physicians indicate that approximately one in four treated patients should have initiated therapy sooner which underscores continued opportunities for earlier identification, referral, and treatment initiation.

Today’s market remains focused primarily on treatment initiation. Approximately nine-in-ten patients receiving Rezdiffra or Wegovy have not used a prior prescription therapy for MASH, indicating that growth is being driven largely by patients entering pharmacologic treatment rather than switching between approved agents.

Physicians are more likely to extend the treatment trial, optimize dosage, or augment the regimen than discontinue therapy immediately when current therapies do not produce the desired results. Physicians typically allow approximately five to six months before assessing the success of Rezdiffra or Wegovy, reflecting expectations for gradual clinical improvement and the limited number of approved MASH-specific alternatives.

This tendency to stay the course is particularly important given that approximately one-third of treated patients do not achieve optimal results. For now, limited alternatives appear to be encouraging physicians to optimize existing therapy rather than move quickly to another treatment, but that dynamic could shift as additional mechanisms enter the market.

Early use of Rezdiffra and Wegovy together illustrates how physicians are beginning to address MASH through complementary therapeutic approaches. Nearly half of patients not currently receiving the two therapies in combination are considered potential candidates for dual therapy, particularly those with advanced fibrosis and metabolic comorbidities.

Rezdiffra is selected primarily for fibrosis improvement and liver-directed disease modification, while Wegovy is differentiated by weight loss and metabolic benefits. When Rezdiffra is added to Wegovy, physicians predominantly seek greater fibrosis improvement. When Wegovy is added to Rezdiffra, additional weight-loss and fibrosis benefits drive the decision. These patterns suggest that physicians are matching therapies to individual clinical priorities rather than viewing the products as interchangeable.

“Prescription treatment has advanced MASH care, but the market is still at an early stage in determining how to manage patients who do not achieve optimal results,” said Jim Hickey, Gastroenterology Franchise Head at Spherix Global Insights. “Physicians are currently giving therapies more time and considering augmentation when appropriate, particularly for patients with advanced fibrosis. As additional mechanisms become available, some of these patients may become candidates for switching, creating a more complex competitive environment.”

The current preference for longer treatment trials and augmentation may evolve as additional MASH therapies become available. Patients who are partially controlled or require treatment modification represent a potentially important population for emerging agents offering differentiated efficacy, safety, tolerability, or applicability to specific patient phenotypes.

For future entrants, differentiation may depend not only on improving liver-directed or metabolic outcomes, but also on addressing gaps left by current therapies or offering complementary mechanisms suitable for combination use. As the market matures, long-term positioning will increasingly depend on how physicians sequence, combine, optimize, and potentially switch therapies based on fibrosis improvement, steatohepatitis resolution, weight loss, metabolic outcomes, and real-world treatment durability.

About Patient Chart Dynamix™

Patient Chart Dynamix™ is an independent, data-driven service unveiling real patient management patterns through rigorous analysis of large-scale patient chart audits. Insights reveal the “why” behind treatment decisions, include year-over-year trending to quantify key aspects of market evolution, and integrate specialists’ attitudinal and demographic data to highlight differences between stated and actual treatment patterns.

About Spherix Global Insights

Spherix Global Insights is a leading independent provider of market intelligence and advisory services for specialty pharmaceutical and biotech markets. By combining physician, patient, and payer perspectives into a single integrated view, Spherix helps brand teams, market access stakeholders, and investors understand how a specialty market actually behaves, not how any one stakeholder describes it. The firm operates eight dedicated therapeutic franchises: Central Nervous System, Dermatology, Gastroenterology, Hematology, Nephrology, Oncology, Ophthalmology, and Rheumatology, alongside a fully dedicated Market Access team. Each franchise is led by hyper-focused analysts and researchers who track these specialty areas full-time, drawing on independently curated communities of vetted practicing specialists, KOLs, patients recruited through treating physicians and advocacy partners, and medical and pharmacy directors at commercial and government payers. Spherix delivers quarterly trending, launch tracking, chart audits, KOL synthesis, patient experience research, and payer and market access intelligence that support confident, strategic decision-making across the pharma lifecycle. Trusted by 19 of the top 20 pharmaceutical and biotech organizations, Spherix has been a go-to resource for more than a decade for leading brands, market access stakeholders, industry media outlets, financial analysts, professional organizations, and patient advocacy groups seeking an unbiased, holistic view of specialty markets.

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NOTICE: All company, brand, or product names in this press release are trademarks of their respective holders. The findings and opinions expressed within are based on Spherix Global Insights’ analysis and do not imply a relationship with or endorsement of the companies or brands mentioned in this press release.

Jim Hickey, Gastroenterology Franchise Head
Spherix Global Insights
484-879-4284
james.hickey@spherixglobalinsights.com