after enrollment you are assigned by a computer system to receive either efimosfermin alfa or a matching placebo.

the assignment is concealed from you and from the study staff (double‑blind).

before the first dose you undergo a series of examinations that include a liver biopsy, blood tests, and imaging studies to document the severity of metabolic dysfunction‑associated steatohepatitis (mash).

the results serve as the reference point for all later comparisons.

the initial dose of the assigned product is given as a subcutaneous injection (injection under the skin).

the product is supplied as a powder for solution for injection; the dose specified in the protocol is 0 mg (placeholder for the study‑defined amount).

the injection is performed by qualified study personnel.

subsequent doses are administered according to the study schedule, continuing for up to 52 weeks.

each dose is given as a subcutaneous injection of the same amount as the first dose.

throughout the 52‑week period you attend scheduled clinic visits to monitor for side effects, to have blood drawn, and to assess overall health.

any adverse events are recorded and evaluated by the study team.

at the end of week 52 you undergo repeat assessments that include a liver biopsy, blood tests, and imaging.

the data are used to determine whether there is improvement in liver fibrosis and steatohepatitis compared with the baseline values.

participants may continue the assigned study medication beyond week 52, up to month 48, if they remain in the trial.

during this extended period the same dosing schedule and safety monitoring continue.

at month 48 a final set of assessments similar to those at week 52 is performed.

the study also measures the concentration of efimosfermin alfa in the blood to evaluate drug exposure.