Akero hopes to begin Phase III study of efruxifermin this year, with 89bio working to enter Phase III with pegozafermin in 2024. But just behind them, Boston Pharmaceuticals thinks it has a convenience and immunogenicity edge.

With its GLP-1 analog already a stalwart in type 2 diabetes and weight loss, Novo Nordisk is investigating semaglutide as monotherapy and in combination regimens to treat non-alcoholic steatohepatitis.

At AASLD, 89bio presented subgroup analysis from its successful Phase IIb NASH study indicating that the drug may meaningfully reduce fibrosis even in the sickest patients, those with cirrhosis.

Already prepping Phase III trials of efruxifermin in pre-cirrhotic NASH patients, Akero says it will go ahead with Phase III plans in cirrhotic patients despite missing the fibrosis endpoint in a Phase IIb trial.