EASL 2026 MASH Mechanism Map After Day 2 — GLP-1/Glucagon Peptides vs THR-β Agonism vs RNAi vs FASN Inhibition vs FGF21 Analogs
EASL 2026's first two days clarified the MASH-therapeutics competitive map across five mechanism classes. GLP-1/glucagon dual peptides: Altimmune pemvidutide (48-week IMPACT data, Best of EASL), Boehringer survodutide (NEJM 47-62% MASH improvement, LIVERAGE Phase 3), MetaVia DA-1726 (48 mg Phase 1). THR-β agonists: Madrigal Rezdiffra (only FDA-approved MASH therapy, eight EASL posters), Aligos ALG-055009 (46.2% liver-fat reduction Phase 2a). RNAi: Arrowhead ARO-INHBE (Activin E/ALK7, 44% liver fat, tirzepatide combination). FASN inhibition: Sagimet denifanstat + Rezdiffra combination. FGF21 analogs: the Akero efruxifermin (Novo $5.2B acquisition) and 89bio pegozafermin (Roche $3.5B acquisition) programs anchoring the most-acquired MASH mechanism. Plus galectin-3 inhibition (Galectin belapectin NAVIGATE) and pan-PPAR agonism (Inventiva lanifibranor NATiV3 Phase 3). The GLP-1/glucagon peptide class leads on combined weight-loss-plus-liver effect; the FGF21 and THR-β classes lead on pure antifibrotic mechanism. Combination therapy across mechanism classes is the emerging 2026 thesis.