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The ESSENCE trial, published in the New England Journal of Medicine in April 2025, provides strong evidence for semaglutide (the drug in Wegovy) in fatty liver disease

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MACE-5 (all-cause death, MI, stroke, heart failure event, coronary revascularisation) 44 events on retatrutide, 52 on placebo: In-study: HR 0.82 (95% CI 0.551.22) On-treatment: HR 0.73 (95% CI 0.471.12) MACE-3 (CV death, MI, stroke) 27 events on retatrutide, 23 on placebo: In-study: HR 1.12 (95% CI 0.641.96) On-treatment: HR 0.92 (95% CI 0.511.65) Lilly states plainly that MACE occurred less frequently than anticipated in both arms

Its 28-day usability window after opening is specifically designed for this use case, and using sterile water in a multi-dose context introduces a real and unnecessary contamination risk with every additional needle insertion

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These same visual principles apply when evaluating whether any peptide has expired , making visual inspection a universal skill for anyone working with peptide compounds