Wegovy and MASH: new liver analysis

What happened

On 1 October 2026, Novo Nordisk reported a new analysis of liver fat in people taking Wegovy, presented at the European Association for the Study of Diabetes (EASD) annual meeting in Milan. It pooled data from two phase 3b trials, STEP UP and STEP UP T2D, and highlights a subgroup who had excess liver fat at the start. We don’t repeat its figures. Novo Nordisk describes the work as a post hoc analysis (planned after the trials ended) that is exploratory, and says it was not a pre-specified primary or secondary endpoint, meaning a result the researchers committed in advance to measure and report.

MASH (metabolic dysfunction-associated steatohepatitis) is a form of fatty liver disease in which fat in the liver comes with inflammation and, over time, can lead to scarring called fibrosis.

The release says the pooled group included people taking Wegovy at 7.2 mg and at 2.4 mg. It also says Novo Nordisk is investigating semaglutide 2.4 mg in MASH and that semaglutide 7.2 mg is not being investigated for the treatment of MASH.

What it means in Canada

Wegovy’s Canadian product monograph (the official prescribing document) lists three uses: chronic weight management in certain adults and adolescents, reducing the risk of non-fatal heart attack in adults with established cardiovascular disease and a BMI of 27 or higher, and treatment of non-cirrhotic MASH in adults with moderate to advanced liver fibrosis (stages F2 to F3).

Health Canada authorized the MASH use under its Notice of Compliance with conditions policy. The monograph describes that as access granted on the condition that the company carries out further trials to verify the expected benefit. It says the MASH authorization is based on improvements seen in liver tissue samples and that continued approval may depend on a confirmatory trial.

Novo Nordisk’s release also says semaglutide 2.4 mg is approved for MASH under the Wegovy brand in the United States, Canada, the United Kingdom, China and several other markets. We checked the Canadian part: the monograph we read, with a date of authorization of 10 December 2025, lists it, so it doesn’t rest on the company’s statement alone.

Public coverage is a separate question. BC PharmaCare published a decision on 18 December 2025 listing Wegovy as a non-benefit, and that review covered chronic weight management in adults with a BMI of 27 or higher and established cardiovascular disease, not MASH. Ontario’s formulary page for Wegovy (a formulary is the list of drugs a plan pays for) shows a coverage status of Off-Formulary Interchangeable, a listing date of 31 August 2026 and no amount paid by the Ministry of Health. It doesn’t mention MASH either. We can’t say how either plan would treat a request for the MASH use, and we haven’t confirmed coverage for it with any plan. Our coverage pages and Wegovy cost page show what we have checked so far.

What hasn’t changed

An exploratory analysis doesn’t change an approved use. Wegovy’s approved uses in Canada are the ones Health Canada authorized in the monograph, and a conference analysis that Novo Nordisk says was not a pre-specified endpoint doesn’t amend them. The monograph lists doses up to 2.4 mg and doesn’t mention a 7.2 mg dose, even though the release’s pooled group included people taking 7.2 mg.

The release is about trial results, not Canadian prices or drug plan rules, so nothing about what you would pay at a pharmacy has changed. Our Wegovy cost page explains what goes into a pharmacy’s price, and our Ontario Wegovy page covers that province’s plan.

What happens next

The monograph says continued approval for the MASH use may be contingent on a confirmatory trial verifying clinical benefit. Neither Health Canada nor Novo Nordisk gave a date for that in the sources we read, and we won’t guess one.

We will add a dated update if a provincial plan publishes a decision on Wegovy for MASH or if Health Canada changes the monograph. For decisions about your own liver health or treatment, talk to a prescriber or pharmacist. You can also read our report on survodutide phase 3 results, and compare telehealth providers for assessment and prescribing, which is separate from what the medication costs.