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NASH Liver Peptides 2026 Update: Triple-Agonist vs Dual-Agonist Comparison
| Peptide Class | Mechanism | NASH Resolution Rate (%) | Fibrosis Improvement (%) | Mean Weight Loss (%) | Primary Limitation | Professional Assessment ||—|—|—|—|—|—|| Triple-Agonist (GLP-1/GIP/Glucagon) | Activates three metabolic pathways: appetite suppressi
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- | Peptide Class | Mechanism | NASH Resolution Rate (%) | Fibrosis Improvement (%) | Mean Weight Loss (%) | Primary Limitation | Professional Assessment ||—|—|—|—|—|—|| Triple-Agonist (GLP-1/GIP/Glucagon) | Activates three metabolic pathways: appetite suppression, adipose remodeling, hepatic fat oxidation | 74% (retatrutide Phase II) | 56% | 24.2% | GI side effects in 38% during titration; requires structured protein intake to prevent lean mass loss | Best option for advanced fibrosis (F2–F3) where direct hepatic fat oxidation is needed; highest resolution rates but demands careful dose escalation || Dual-Agonist (GLP-1/Glucagon) | Combines appetite suppression with direct hepatic lipolysis via glucagon-mediated CPT1 upregulation | 68% (mazdutide MOMENTUM) | 51% | 18.7% | Less adipose remodeling than triple-agonists; visceral fat reduction slower | Strong middle-ground option; effective for F1–F2 fibrosis with lower side effect burden than triple-agonists || Single-Target GLP-1 Agonist