Fibrosis Lessens After Metabolic Surgery

This study is looking for adults aged 18 to 75 who have both obesity and MASH (a type of liver disease with scarring). To be considered, you would generally need to be a candidate for weight-loss surgery and eligible for general anaesthesia. You'll also need to meet certain health checks, including having specific results from liver tests that suggest scarring.

There are also some specific health requirements related to your weight (your BMI should be between 35 and 70), and you should not have lost a lot of weight in the six months before joining. If you have type 2 diabetes, your condition needs to be stable. Women who could become pregnant would need to use reliable contraception during the study. The medical team will check all these details carefully to see if this study is suitable for you.

If you decide to take part and are found eligible, you would first provide your informed consent, meaning you understand the study and agree to participate. You would then have a liver biopsy (a small sample taken from your liver) if you haven't had one recently that meets the study's needs. This helps the doctors understand your liver health at the start.

About 120 patients will be randomly split into two groups – like flipping a coin for either treatment. One group will receive metabolic (weight-loss) surgery, and the other will receive medical treatment using incretin-based therapies (medicines like semaglutide, tirzepatide, or liraglutide, which are given as injections or sometimes tablets, potentially with other medicines). Both groups will be followed closely for two years. At the end of these two years, you would have another liver biopsy to see how your liver health has changed. The main study site is in Cleveland, Ohio, USA, but it's a multi-centre international study.