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July 2025
In this powerful and timely episode, Robin Soto, FNP at UC San Diego Health, explores the deep-rooted health disparities impacting patients with MASH (metabolic dysfunction-associated steatohepatitis) and MASLD (metabolic dysfunction-associated steatotic liver disease). With a focus on equity in liver care, Robin highlights the disproportionate burden of disease in Hispanic and underserved populations and the complex interplay of genetics, socioeconomic status, healthcare access, and systemic bias that drives these outcomes. She shares actionable strategies for advanced practice providers (APPs) to implement culturally sensitive communication, bias-conscious screening protocols using tools like FIB-4, NAFLD fibrosis score, and transient elastography, and how to leverage telehealth and community partnerships to bridge gaps in care. Robin also addresses the importance of culturally relevant dietary counseling, inclusive family engagement, and motivational interviewing to enhance adherence and improve long-term outcomes. Whether you're in primary care, hepatology, or community health, this episode offers a roadmap to advance health equity in the management of fatty liver disease.
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MASLD Pharmacotherapy With Jonathan Yeh
August 2025
In this GHAPP MASLD Community Network Education Series, Jonathan Yeh, PA from Columbia University Irving Medical Center, reviews the latest advances in pharmacotherapy for MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). This presentation explores the evolution from NAFLD to MASLD, highlighting why metabolic dysfunction is central to disease progression. Jonathan discusses the role of lifestyle modification, GLP-1 receptor agonists (such as semaglutide and tirzepatide), vitamin E, pioglitazone, and bariatric surgery, while focusing on resmetirom—the first FDA-approved therapy for adults with non-cirrhotic MASH and moderate to advanced fibrosis. The session explains how resmetirom works as a thyroid hormone receptor beta agonist, its clinical trial evidence from the MAESTRO-NASH study, patient eligibility, safety considerations, drug–drug interactions, and monitoring recommendations. With ongoing studies and expanding treatment options, this discussion provides clinicians with practical strategies for managing MASLD and MASH, improving liver outcomes, and addressing the challenges of insurance access and long-term therapy.
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NITs: A Practical Overview: Navigating the Basics
July 2025
In this episode, Christie Morrison breaks down the fundamentals of non-invasive testing (NITs) for evaluating patients with fatty liver disease, including MASLD and MASH. She explains the key differences between steatosis (MASLD) and steatohepatitis (MASH), highlighting how non-invasive tests can replace liver biopsy for staging fibrosis. Christy reviews common tools like FIB-4, NAFLD fibrosis score, Enhanced Liver Fibrosis (ELF) score, transient elastography (FibroScan), and MR elastography, and outlines how to choose the right test based on patient factors such as co-morbidities, geography, access to labs, and imaging availability. The episode also emphasizes the importance of fibrosis risk stratification, interpreting FIB-4 cutoffs, and monitoring liver stiffness or ELF scores after initiating lifestyle or pharmacologic treatment—including newer therapies like resmetirom. This is a must-watch for APPs, GI clinicians, and primary care providers seeking to improve care pathways and outcomes in patients with metabolic liver disease through practical, accessible strategies for fibrosis detection and management.
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MASLD Basics With Gabriella McCarty
August 2025
In this educational session, Gabriella McCarty, NP at North Shore Gastroenterology, shares practical insights into Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH. Drawing from over 25 years of experience in GI, IBD, and hepatology, she explains how many fatty liver patients are discovered incidentally during workups for unrelated issues such as GERD or routine colonoscopy. Gabriella reviews the new global terminology (MASLD replacing NAFLD, MASH replacing NASH), outlines key metabolic risk factors that define MASLD, and walks through the role of non-invasive tests (FIB-4, FibroScan, ELF, ultrasound) in staging fibrosis. She emphasizes the importance of early detection, patient education, and primary care involvement in identifying at-risk individuals before progression to advanced fibrosis, cirrhosis, or liver cancer. This presentation highlights how MASLD can silently progress, why primary care and GI collaboration are critical, and the growing need for global awareness and prevention of progressive liver disease.
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Monitoring for MASLD in Type 2 Diabetes
July 2025
In this episode, Kelly Smeester, PA-C from South Denver Gastroenterology, explores the critical intersection of type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD). Drawing from her background in both hepatology and endocrinology, Kelly offers practical, evidence-based strategies for non-invasive monitoring of liver fibrosis in patients with diabetes who may initially appear low risk. She highlights the utility of tools like FIB-4, ELF score, FibroScan, and MR elastography, while emphasizing the limitations of relying solely on liver function tests (LFTs). Kelly recommends annual FIB-4 screening—easily calculated with existing lab values—and discusses when to escalate to more advanced diagnostics. She also shares how advanced practice providers (APPs) can seamlessly integrate MASH education, lifestyle counseling, and routine screening into the diabetes care workflow, supporting early intervention and long-term liver health. This episode is a must-listen for clinicians looking to optimize care for patients at risk of silent liver disease progression in the setting of metabolic co-morbidities.
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Comparing F3 and F4 Fibrosis With Alison Moe
August 2025
Join Alison Moe, PA-C, from Atlanta Gastroenterology Associates, for a case-based, practical exploration of how to identify, risk stratify, and manage patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH (Metabolic Dysfunction-Associated Steatohepatitis). In this engaging session from the GHAPP MASLD Community Network, Alison walks through the clinical implications of differentiating F3 fibrosis from F4 cirrhosis, highlighting the importance of non-invasive testing tools such as FIB-4, FibroScan (KPA scores), CAP scores, and ELF tests in determining appropriate treatment pathways. Learn how platelet counts, ALT/AST levels, and liver stiffness scores play a critical role in determining whether a patient qualifies for medical therapy like resmetirom (Rezdiffra), or instead requires HCC surveillance and screening for portal hypertension. The session also reviews how to integrate GLP-1 receptor agonists for patients with concurrent type 2 diabetes and obesity, and why diet and lifestyle modifications remain foundational in all stages of care. Allison emphasizes FDA treatment criteria, shares decision-making strategies around ambiguous fibrosis scoring, and explains how to use real-world diagnostic markers to drive individualized liver care. This is an essential update for GI, hepatology, and primary care providers managing the growing population of MASLD/MASH patients.
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Discordant NITs: The Gray Zone
August 2025
Join Melissa Franco, PA at the University of Miami, for an in-depth episode of the GHAPP MASLD Community Network podcast focused on discordant non-invasive tests (NITs) and navigating the "gray zone" of liver fibrosis staging. Melissa walks through common real-world scenarios where FIB-4, FibroScan, ultrasound, ELF score, and MR elastography deliver conflicting results—exploring why this happens and how to approach it clinically. Learn how patient factors such as obesity, alcohol use, co-morbidities, medications, and test limitations can impact NIT interpretation. Discover Melissa’s expert strategies for re-evaluating results, when to consider liver biopsy, and how to communicate these complexities with patients. From understanding how false elevations occur to using imaging and labs to confirm or exclude advanced fibrosis, this episode provides a practical and evidence-based approach to staging MASLD and MASH when results don’t align. Whether you're managing metabolic liver disease in hepatology or primary care, this is essential listening for interpreting liver diagnostics in nuanced clinical settings.
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MASLD Pharmacotherapy With Jordan Mayberry
July 2025
Join Jordan Mayberry, MPAS, PA-C from UT Southwestern, for an insightful session from the GHAPP MASLD/MASH Community Network focused on the evolving landscape of pharmacotherapy in MASLD and MASH. This presentation explores evidence-based strategies for treating metabolic dysfunction–associated steatotic liver disease (MASLD), with an emphasis on weight loss, diabetes management, and liver-directed therapies. Jordan breaks down key data on GLP-1 receptor agonists, SGLT2 inhibitors, Vitamin E, pioglitazone, and highlights the latest clinical evidence supporting the use of Resmetirom—the first FDA-approved treatment for MASH with stage 2 or 3 fibrosis. Learn how these therapies fit into hepatology practice, including clinical considerations, side effect management, and patient selection. Stay up to date on ongoing research, treatment duration, and real-world application of these new therapies. Don’t forget to register and join the GHAPP MASLD/MASH Community Network for continued education and access to valuable resources.
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Comparing F3 and F4 Fibrosis With Michelle Barnett
July 2025
In this installment of the GHAPP MASLD Community Network, Michelle Barnett, PA-C from Peak Gastroenterology in Colorado Springs, presents a deep dive into the clinical management of MASH—formerly known as NASH or non-alcoholic steatohepatitis. Through two comparative case studies, Michelle explores the nuances of diagnosing and managing patients with F3 and F4 fibrosis. Learn how to effectively use non-invasive diagnostic tools like FIB-4, FibroScan, and ELF testing, and gain valuable insights into stratifying fibrosis risk, monitoring hepatocellular carcinoma (HCC), and determining when resmetirom is appropriate. This session also covers practical guidance on nutrition, exercise, medication safety, and multidisciplinary care for patients with advanced liver disease. Whether you're a hepatology specialist or a primary care provider navigating the MASLD/MASH landscape, this video offers actionable strategies to improve long-term patient outcomes and reinforces the critical role of lifestyle intervention and liver disease surveillance.
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MASLD Pharmacotherapy With Gabriella McCarty
August 2025
In this presentation, Gabriella McCarty, NP at North Shore Gastroenterology, explores the evolving management of Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and MASH with a focus on pharmacotherapy. Drawing from her 26 years in gastroenterology, IBD, and hepatology, she explains how fatty liver disease is often detected incidentally and highlights the importance of early diagnosis and patient education. Gabriella reviews the three-pillar approach to treatment—lifestyle and weight loss strategies, cardiovascular risk reduction, and emerging liver-directed therapies. She discusses the role of GLP-1 receptor agonists, Vitamin E, Pioglitazone, and the first FDA-approved therapy, Resmetirom, detailing their mechanisms, benefits, and safety considerations. With insights from the MAESTRO-NASH trial and real-world experience using non-invasive tests like FibroScan, CAP scores, and ELF testing, this session provides practical guidance for clinicians managing MASLD/MASH and preventing disease progression to cirrhosis or hepatocellular carcinoma.
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Lifestyle Management With Whitney Steinmetz
July 2025
In this case-based clinical discussion, Whitney Steinmetz, FNP from Presbyterian Medical Group in Albuquerque, New Mexico, offers an in-depth review of lifestyle management strategies for patients with MASLD and MASH. Using the case of a 65-year-old male with persistently elevated ALT and metabolic syndrome, she highlights the importance of individualized, culturally competent counseling around nutrition, exercise, and behavioral change. Steinmetz outlines how tools like the FIB-4 score and FibroScan can help guide management and determine fibrosis risk, while emphasizing the critical role gastroenterology providers must play in addressing obesity, insulin resistance, and dietary habits. From the utility of motivational interviewing and realistic meal planning to the integration of caloric restriction and personalized exercise, this presentation equips clinicians with practical tools to support sustainable behavior change in patients with metabolic liver disease. Genetic factors, social determinants of health, and patient empowerment are all addressed, offering a holistic perspective on disease progression and prevention.
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