Novo Nordisk Gains a Chinese MASH Approval as Its Semaglutide Story Moves Down the Age Curve

China clears Wegovy for MASH, giving Novo Nordisk a new indication as shares lag and ziltivekimab trials are halted.

China's drug regulator has signed off on Wegovy for the treatment of metabolic dysfunction-associated steatohepatitis, handing Novo Nordisk a fresh indication for its flagship semaglutide franchise in one of the world's largest healthcare markets. Reuters reported the approval, which extends the drug beyond diabetes and obesity into liver disease and opens an additional growth lane for the Danish group.

The regulatory win lands at a moment when Novo Nordisk could use one. The shares are trading around EUR 38.16 and have shed 6.6% across the past seven trading sessions alone, leaving them down 13% year-to-date and roughly 30% below January's 52-week high of EUR 54.86.

A paediatric milestone with long-term implications

Further out on the horizon sits an arguably more consequential development. On September 7, Novo Nordisk reported results from the Phase 3 STEP Young trial, which tested once-weekly semaglutide in children aged six to under twelve living with obesity. The primary endpoint was met, with BMI reduction after 68 weeks coming in pronounced.

One figure stands out: 40.4% of treated children were no longer classified as obese at the end of the study, compared with none in the placebo arm. Full data are slated for presentation in November at ObesityWeek 2026 in Washington.

The result raises a question that reaches well past Novo Nordisk's own balance sheet. Is obesity medicine shifting from an adult treatment model toward a lifelong prevention strategy? A patient treated at ten does not carry the metabolic consequences of excess weight into their forties.

For a company whose stock has fallen 14% since the start of the year, that is more than a public-relations headline. It represents an attempt to open a new, decades-long market segment while the established one comes under pressure.

Ziltivekimab: the setback still reverberating

The troubles of the prior week have not faded. On the preceding Wednesday, Novo Nordisk halted the Phase 3 HERMES and ATHENA trials of ziltivekimab after an independent monitoring committee concluded the studies no longer had a viable path to success.

The stock has since slipped 0.7% — a modest move, but a telling one for a pipeline that has lately disappointed more often than it has surprised. Back in July, the large ZEUS study had already failed, a trial designed to show that ziltivekimab reduces cardiovascular events in patients with atherosclerosis and chronic kidney disease.

All that remains of the ziltivekimab programme is ARTEMIS, a study of acute treatment following heart attack, with readouts expected in the first half of 2027. Whether it delivers a success is an open question.

Meanwhile, China confirmed in late August that it had accepted for review the filing for oral Wegovy — a market that is likely to prove decisive over the coming years in determining just how globally the obesity business can scale.

Buybacks as a quiet counterweight

While the pipeline swings between promise and disappointment, Novo Nordisk is steadily executing its share repurchase programme. Through September 4, the company had bought back roughly 32 million B-shares since February at an average price of DKK 281.63, a transaction volume of just over DKK 9 billion.

The programme runs until February 2027 and carries a total envelope of DKK 11.2 billion. For a company whose stock last closed at EUR 38.08 — 31% below its 52-week high of EUR 54.86 — the message is clear enough: management sees value in its own paper even as the market stays skeptical.

Annualised volatility of 32% and an RSI of 38.4 suggest investors are undecided on how to weigh pipeline setbacks against structural growth potential.

Competition and pricing pressure persist

Novo Nordisk is also pushing ahead with its oral obesity business. A little over a week ago, the company launched the Wegovy pill in Germany, broadening its position in the European market against competition from Eli Lilly. Since that market debut, the stock has lost about 4.9%, a sign that investors are currently paying less attention to operational news than to pricing pressure in the United States.

There, Novo Nordisk pledged in November to cut prices for its semaglutide products Wegovy and Ozempic and to offer certain insulin products for USD 35 per month through the TrumpRx programme — a concession made within the framework of price negotiations with pharmaceutical companies pushed by the Trump administration.

The technical picture remains bruised. With an RSI of 38.7 and a share price sitting 7.7% below its 50-day moving average, the uncertainty of recent weeks is plainly reflected. The Chinese approval of Wegovy for the MASH indication now provides at least one fundamental bright spot that could bolster the company's growth story beyond its established indications.

On September 21, Novo Nordisk holds its capital markets day in London — for a company at this crossroads, more than a routine engagement. It is the moment when management must explain whether the paediatric expansion of the semaglutide business can offset the lost bets on ziltivekimab.