A positive interim analysis from the ESSENCE MASH trial, strong NHS tirzepatide uptake continues, and NICE opens consultation on lower BMI thresholds for obesity pharmacotherapy.

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ESSENCE Trial — Semaglutide in MASH: Positive Interim Analysis

Novo Nordisk announced a positive interim analysis from the ESSENCE Phase 3 trial of semaglutide 2.4 mg in adults with metabolic dysfunction-associated steatohepatitis (MASH) and liver fibrosis.

Interim results (72 weeks, n=1,200 of planned 1,800):

• MASH resolution without worsening fibrosis: 62.9% semaglutide vs 18.1% placebo (p<0.001)
• ≥1 stage fibrosis improvement: 37.2% semaglutide vs 22.6% placebo (p<0.001)
• Both co-primary endpoints met

Full results are expected in Q2 2026.

UK context: MASH affects an estimated 2–3% of UK adults (approximately 1.5 million people), with the majority having concurrent obesity. Current treatment is limited to lifestyle modification and management of comorbidities.

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NHS Tirzepatide — 5-Week Update

• Cumulative patients: 42,000
• Weekly prescribing rate: Stabilising at approximately 7,000–8,000 new patients per week
• Dose escalation: 18% of patients have escalated to 5 mg; 4% to 10 mg
• Adverse event reports: 2,100 Yellow Card reports received (predominantly GI events); no unexpected safety signals

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NICE — Lower BMI Thresholds: Scoping Document Published

NICE has published a scoping document for consultation on the evidence review of lower BMI thresholds for obesity pharmacotherapy eligibility.

Proposed scope:

• Population: Adults with BMI 27–29.9 kg/m² and ≥1 cardiometabolic risk factor
• Interventions: All currently licensed obesity pharmacotherapies
• Key questions: Is pharmacotherapy clinically effective and cost-effective at BMI 27–29.9 kg/m² with cardiometabolic risk? Should eligibility criteria be risk-based rather than BMI-based?

The consultation closes 3 April 2026.

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Research Digest

Tirzepatide and PCOS: A Phase 2 trial published in The Lancet showed that tirzepatide 15 mg produced significant improvements in menstrual regularity (73% vs 28% placebo), androgen levels, and insulin resistance in women with PCOS and obesity at 36 weeks.

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This update is prepared for UK healthcare professionals. All prescribing decisions should reference current NICE guidance, the BNF, and individual patient clinical assessment.