Your Liver Just Got Better Treatment Options: Here's What Changed in 2025

2025 marked a turning point for liver health, bringing the first effective medications for fatty liver disease and breakthrough treatments that are reshaping how doctors approach liver care. After years of limited options beyond lifestyle changes, patients now have access to proven therapies that can halt and even reverse liver damage.

What New Medications Are Now Available for Fatty Liver Disease?

The biggest breakthrough came with two new treatments for metabolic dysfunction-associated steatohepatitis (MASH), formerly known as fatty liver disease. The U.S. Food and Drug Administration (FDA) approved semaglutide (Wegovy) in August 2025 for treating MASH in adults with moderate to advanced liver scarring but not cirrhosis. This medication, already known for treating diabetes and obesity, showed remarkable results in clinical trials led by Dr. Arun Sanyal at Virginia Commonwealth University.

"The results from this landmark study across 37 countries provide strong evidence that semaglutide can help patients with MASH by not only improving liver health, but also addressing the underlying metabolic issues that contribute to the disease," said Sanyal, director of VCU's Stravitz-Sanyal Institute for Liver Disease and Metabolic Health.

In the clinical trials, nearly 90% of participants stayed on semaglutide for more than a year. About two-thirds experienced reduced liver inflammation, while more than one-third saw improvements in liver scarring. Another third showed improvements in both inflammation and scarring.

How Are Hepatitis Treatments Advancing?

Hepatitis treatment saw significant progress in 2025, with multiple breakthrough developments across different types of the virus. The FDA approved an expanded use for glecaprevir/pibrentasvir (Mavyret) in June, making it the first therapy approved to treat acute hepatitis C in just 8 weeks with a 96% cure rate.

For hepatitis B patients, besifovir showed promise in improving kidney and bone health in people previously on long-term tenofovir disoproxil fumarate (TDF) treatment. The 48-week study demonstrated that switching to besifovir maintained antiviral effectiveness while reversing some adverse effects of long-term TDF therapy.

Perhaps most notably, brelovitug received FDA Breakthrough Therapy designation for chronic hepatitis D in January 2025. Phase 2 data showed 100% virologic response and up to 78% combined virologic response with normalized liver enzyme levels.

What Other Liver Disease Advances Happened in 2025?

Beyond fatty liver disease and hepatitis, 2025 brought several other important developments in liver care. The FDA accepted FibroScan liver stiffness measurement as a potential surrogate endpoint for MASH clinical trials, marking the first time a noninvasive test received this consideration for liver disease drug development.

Key advances across liver diseases included:

• Pipeline Progress: Pemvidutide showed continued antifibrotic activity in phase 2b trials and advanced to phase 3 testing for MASH treatment
• Diagnostic Innovation: Artificial intelligence-based pathology investigations are reducing the need for liver biopsies in clinical studies
• Patient-Centered Care: Increased focus on addressing psychosocial factors and stigma in chronic liver disease management
• Portal Hypertension: New therapeutics in development for patients with advanced liver disease on the verge of decompensation

However, the year also saw setbacks. Intercept Pharmaceuticals voluntarily withdrew obeticholic acid (Ocaliva) from the U.S. market for primary biliary cholangitis treatment following an FDA request, highlighting ongoing safety challenges in cholestatic liver diseases.

The momentum in liver disease treatment reflects years of research finally paying off. "I think being in the field of hepatology has been very exciting in the last few years," noted Dr. Naim Alkhouri, chief academic officer of Summit Clinical Research. "We have new treatments that are being developed for hepatitis B to achieve functional cure, and I think this will be a great addition for these patients."

These advances are particularly significant given that fatty liver disease affects about 30% of people worldwide, with approximately 15 million Americans potentially having MASH. For the first time, patients and doctors have multiple treatment options beyond diet and exercise, marking a new era in liver disease management.