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MASLD AI 01:32 AM
August 2025
In this expert-led session, Christie Morrison, NP, shares a comprehensive case-based discussion on comparing F3 vs F4 fibrosis in patients with MASH (Metabolic Dysfunction-Associated Steatohepatitis). Through the lens of two real-world clinical scenarios, Christie breaks down the nuanced differences in non-invasive diagnostic tools such as FIB-4, ELF scores, and FibroScan KPA readings, while guiding providers on how to stratify risk, monitor disease progression, and tailor interventions appropriately. Viewers will learn how elevated liver enzymes, declining platelet counts, and steatosis scores influence decision-making in patients with metabolic comorbidities like type 2 diabetes, hypertension, and hyperlipidemia. The session emphasizes evidence-based lifestyle and pharmacologic strategies, including the potential role of resmetirom (Rezdiffra) in F3 fibrosis and why it’s contraindicated in advanced cirrhosis. Learn when to initiate HCC surveillance, how to interpret borderline labs, and the importance of integrating GLP-1s, dietitian referrals, and cardiometabolic care to slow or reverse fibrosis progression. Whether you’re managing intermediate or advanced fibrosis, this educational session provides invaluable insights into optimal MASH care pathways and staging techniques.
Related Podcast
Lifestyle Management With Anthony Derencius
July 2025
Join Anthony Derencius, PA-C, at Pinnacle Clinical Research, for an in-depth, case-based discussion on the role of lifestyle management in MASH and MASLD. In this educational session from the GHAPP MASLD Community Network, Anthony walks through the real-world case of a 65-year-old patient with obesity, diabetes, and suspected metabolic liver disease, highlighting how to interpret non-invasive diagnostics like FIB-4 scores and transient elastography. He explains the clinical significance of metabolic risk factors, genetic predispositions (such as PNPLA3), and how personalized approaches to nutrition and exercise can alter the progression of fatty liver disease. With evidence-based insights on the Mediterranean diet, aerobic vs resistance training, and behavior change strategies, this video offers frontline strategies to support patients in reversing or slowing fibrosis. Watch to learn how providers can combine patient education, lifestyle interventions, and emerging pharmacotherapy to manage MASLD and MASH more effectively. Educational support provided by Madrigal Pharmaceuticals. For more disease state content, visit the GHAPP MASLD Community Network.
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MASLD vs MetALD With Kelly Smeester
September 2025
In this session from the GHAPP MASLD Community Network, Kelly Smeester, PA-C at South Denver Gastroenterology, reviews a patient case to highlight the overlap between metabolic dysfunction–associated steatotic liver disease (MASLD) and metabolic dysfunction plus alcohol-associated liver disease (MetALD). Using real-world labs, FibroScan values, CAP scores, and the PEth biomarker, she explains how clinicians can distinguish MASLD from MetALD and alcohol-related liver disease. The discussion covers key metabolic risk factors such as PCOS, hypertension, and hyperlipidemia, the impact of moderate alcohol intake, and how these drivers accelerate fibrosis progression and increase the risk of decompensation. Viewers will learn how to evaluate alcohol use through standardized definitions, clinical questionnaires, and biomarkers, as well as best practices for patient education, lifestyle counseling, and management, including diet, exercise, pharmacologic options, and hepatocellular carcinoma (HCC) surveillance. This case-based talk emphasizes why accurate diagnosis and objective assessment of alcohol consumption are essential for both clinical care and research in steatotic liver disease.
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MASLD Pharmacotherapy With Elizabeth Goacher
September 2025
Elizabeth Goacher, PA-C from Duke Medical Center in Durham, NC, delivers an in-depth discussion on pharmacotherapy for MASLD/MASH, highlighting both current treatment options and emerging therapies. She reviews the role of GLP-1 receptor agonists in managing obesity and type 2 diabetes while offering secondary benefits for liver health, and addresses key considerations for procedural planning due to delayed gastric emptying. Elizabeth also explores the ongoing debate around vitamin E and pioglitazone, summarizing data from pivotal trials and guideline recommendations. The session emphasizes the groundbreaking approval of resmetirom, the first FDA-approved medication for MASH with F2–F3 fibrosis, detailing its mechanism as a thyroid hormone receptor beta agonist, trial outcomes, safety profile, and practical prescribing considerations, including payer coverage and drug interactions. This presentation provides hepatology and GI providers with practical insights on staging, non-invasive testing strategies (FIB-4, FibroScan, ELF, MRE), treatment sequencing, and how to integrate pharmacotherapy with lifestyle and multidisciplinary care to optimize outcomes in metabolic liver disease.
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MASLD Basics With Ann Moore
September 2025
In this episode of MASLD Basics, Ann Moore, NP with Arizona Liver Health, explains the new terminology and approach to what was once called fatty liver disease. She breaks down how “NAFLD” is being replaced with steatotic liver disease and how patients are now categorized based on underlying drivers such as metabolic dysfunction, alcohol use, or other conditions. Ann highlights why MASLD and MASH are the most common and important to recognize, what risk factors providers should look for, and why early detection matters. She also discusses how primary care teams can use simple non-invasive tests, lifestyle changes, and new treatment options to identify at-risk patients before fibrosis and cirrhosis develop. This talk is designed to give APPs, clinicians, and healthcare providers a clear, practical overview of the evolving landscape of liver disease care.
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Alcohol and MASLD/MASH: Navigating the Complex Relationship
July 2025
In this insightful episode, Oyin Penny, NP with Premier Gastroenterology of Kansas City, addresses the complex clinical challenge of managing patients with MASLD (metabolic dysfunction-associated steatotic liver disease) who also consume alcohol. Oyin shares practical, evidence-based strategies for screening alcohol use in MASLD and MASH, emphasizing the importance of creating a nonjudgmental, patient-centered environment. She outlines how to use tools like PEth (phosphatidylethanol) testing to objectively quantify alcohol intake and explains the synergistic hepatotoxicity that occurs when alcohol use coexists with metabolic liver disease. Oyin also explores when to initiate non-invasive tests (NITs), why alcohol can distort fibrosis staging, and how to time assessments and treatment appropriately. From setting SMART goals to recommending behavioral support, medications like naltrexone, and exploring mental health and social work interventions, this episode offers a full-spectrum approach to managing high-risk patients. Whether you're a GI, hepatology provider, or in primary care, this episode provides tools for personalized care, alcohol harm reduction, and effective long-term MASLD management.
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Non-Invasive Testing With Oyin Penny
August 2025
In this GHAPP MASLD Community Network presentation, Oyin Penny, FNP, from Premier Gastroenterology of Kansas City, explores the evolving role of non-invasive testing (NITs) in assessing MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). Through a detailed case study of a 65-year-old male with obesity, diabetes, hypertension, and hyperlipidemia, we review how imaging biomarkers such as FibroScan, MR Elastography, CAP score, and MRI-PDFF, as well as clinical prediction tools like FIB-4 and ELF score, are applied to evaluate fibrosis risk and guide management decisions. This session highlights the strengths and limitations of various NITs, emphasizes the importance of accurate fibrosis staging, and outlines when to repeat testing, escalate to hepatology referral, or initiate therapy. The discussion underscores the critical need for early detection, risk stratification, and proactive management of liver disease in patients with metabolic risk factors to prevent progression to cirrhosis and improve long-term outcomes.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Anthony Derencius, PA-C at Pinnacle Clinical Research, clears up some of the most common misconceptions about liver health—offering valuable insights for both patients and healthcare providers. With extensive experience in hepatology, Anthony emphasizes that liver disease is often silent and asymptomatic, meaning many individuals may feel completely fine while living with a significant liver issue. He cautions against relying on a single lab result or imaging test to determine liver status, especially when assessing for conditions like cirrhosis, and stresses the importance of confirming findings through multiple diagnostic tools over time. Anthony also highlights the need for proactive screening, particularly in patients with risk factors such as obesity, diabetes, or a family history of liver disease. Early detection is key, and he encourages patients to advocate for their liver health by seeking evaluation—even if their provider hasn’t suggested it. This is a must-watch for anyone aiming to better understand the complexities of liver disease and the importance of early and accurate diagnosis.
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Discordant NITs, the Gray Zone
July 2025
Join Lindsay Pratt, PA-C, from the University of Colorado School of Medicine’s Hepatology and Liver Transplant Department, as she unpacks the challenges of interpreting discordant results between non-invasive liver testing tools such as FIB-4 and FibroScan in patients with MASLD and MASH. With over 15 years of clinical experience, Lindsay walks viewers through how age, transaminase levels, platelet count, and patient factors like BMI and fasting status can impact test accuracy and reliability. She emphasizes when to consider advanced diagnostics like MRI elastography (MRE) or liver biopsy, and how to tailor decisions to the individual patient, especially when results don't align. This practical session is ideal for hepatology and GI providers navigating complex liver disease management, and includes tips for communicating test limitations and next steps with patients. Learn how to make informed decisions using non-invasive tests while maintaining patient-centered care in the management of fatty liver disease.
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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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MASLD vs MetALD With Patrick Horne
September 2025
In this case-based session from the GHAPP MASLD Community Network, Patrick Horne, NP explains how to differentiate metabolic dysfunction–associated steatotic liver disease (MASLD) from metabolic dysfunction plus alcohol-associated liver disease (MetALD). Through the story of a 52-year-old patient with F3 fibrosis and severe steatosis, he reviews the modern SLD framework, metabolic risk factors (e.g., BMI, PCOS, hypertension, hyperlipidemia), and how alcohol intake interacts with insulin resistance, the gut microbiome, and hepatic lipid handling to accelerate inflammation and fibrosis. Patrick demonstrates practical tools—clear “standard drink” counseling, thorough history, AUDIT-C screening, and objective biomarkers like PEth—to uncover under-reported alcohol use and classify patients on the MASLD–MetALD–ALD spectrum. Management takeaways include Mediterranean-style nutrition, exercise and weight-loss targets, consideration of pharmacologic options in advanced fibrosis, firm guidance on alcohol cessation, and nuanced discussion of HCC surveillance in F3 disease. Ideal for APPs and hepatology clinicians, this talk delivers actionable algorithms, definitions, and trial-readiness considerations to standardize MetALD assessment and improve outcomes in steatotic liver disease.
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