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FDA-approved MASH drugs are transforming adult care — but kids are still waiting. Pediatric MASLD affects roughly 13% of children and adolescents, yet drugs like resmetirom and semaglutide haven't been approved for under-18s. Early data on GLP-1 receptor agonists look promising, and experts hope adult breakthroughs will fast-track dedicated pediatric trials.
FDA-approved MASH therapies are reshaping adult liver disease care, but children with metabolic dysfunction-associated steatotic liver disease (MASLD) are still without approved pharmacologic options. Experts say the adult breakthroughs — resmetirom and semaglutide — could serve as a catalyst to accelerate pediatric clinical trials, which are urgently needed given how common and underrecognized the condition is.
Pediatric MASLD is as prevalent as asthma, yet current standard-of-care lifestyle interventions fall short for many kids. In one study, only 22–31% of children improved over two years, while ~20% worsened despite treatment. Early retrospective data on GLP-1 receptor agonists in children show meaningful improvements in liver enzymes and steatosis, and a phase 2 trial of resmetirom in children aged 6–17 is now underway.
By the Numbers:
Why it matters: Without dedicated pediatric trials, children with MASH risk progressing to advanced fibrosis with no approved treatment options. Experts stress that acting early — before fibrosis advances — is critical to changing long-term liver outcomes in this population.
