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This conversation is the first segment of SurfingMASH’s July discussion of key events from the first six months of 2025. Co-hosts Jörn Schattenberg, Louise Campbell and Roger Green each chose one topic of personal interest. Today, Jörn Schattenberg discusses two recent papers that demonstrate differences in how individual patients respond to different proteomic tests and what this can mean for individualized treatment plans.

Jörn begins by citing Modulation of megabolic, inflammatory and fibrotic pathways by semaglutide in metabolic dysfunction-associated steatohepatitis, a paper from researchers at Novo Nordisk that Nature magazine posted online on July 21. In this paper, the researchers utilized proteomic testing (aptamer-based SomaSignal NASH tests) to determine whether semaglutide successfully addressed different NAS score elements: steatosis, lobular inflammation, hepatocyte ballooning and fibrosis. The proteomics-based tests indicated an improvement in all four of these elements, but the elements that improved and the amounts of improvement varied among individuals. To Jörn, this suggests that we can use an individual patient's proteomic results to tailor individualized therapy based on the areas in need of improvement, so that the prescriber would know whether the best approach to resolve NAS and reduce fibrosis was one that focused on metabolic issues vs. specific anti-fibrotic effects in the liver. He supports this idea by referring to a paper he had published in JHep Reports. In this paper, he and his colleagues looked at semaglutide Phase 1 and 2 obesity trials, where MASLD was not a criterion for entry. However, analyzing individual patients with the SomaLogic panel revealed that many had some form of MASLD and that semaglutide therapy could resolve the specific MASLD issues.

The rest of the conversation focused on Jörn's conclusion and the potential for tailoring treatment plans to the individual. Lousie hailed the entire concept as extremely helpful not only in selecting a pharmacotherapy but also in providing patients with information they could use to improve their health further. Roger suggests that the kinds of proteomic tests Jörn describes can lead to first-line multi-agent pharmacotherapy to address the disease with agents that collectively will address the individual patient's profile.