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Among the patients who develop NASH, 1020% will progress to higher-grade fibrosis and approximately 5% will develop overt cirrhosis (1) ( Figure 1 Triglycerides (TG) accumulation is likely one of the first steps in the pathophysiology of NAFLD as a result of an impaired free fatty acid (FFA) metabolism in the liver (Figure 2)

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The distinct contributions of each receptor system - GLP-1-mediated improvements in insulin sensitivity and appetite regulation, GIP-mediated enhancement of insulin secretion and adipose tissue function, and glucagon-mediated direct hepatic metabolic modulation and increased energy expenditure - create synergistic benefits when engaged through dual or triple agonist formulations

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