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MASLD AI 10:44 AM
July 2025
In this in-depth clinical discussion, Erin Parkinson, NP from the Tampa General Medical Group Transplant Institute, walks through the nuanced process of differentiating stage 3 and stage 4 fibrosis in patients with MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease). Using two illustrative case studies, she explores key clinical signs, lab values, and non-invasive staging tools such as FibroScan, FIB-4, ELF score, and MR elastography. Parkinson discusses the importance of early identification of advanced fibrosis, the reversibility of stage 3 disease, and the implications of a diagnosis of cirrhosis. Erin outlines evidence-based treatment pathways including lifestyle interventions, use of GLP-1 receptor agonists, and initiation of resmetirom (Rezdiffra) for stage 2–3 fibrosis. For cirrhotic patients, the focus shifts to HCC surveillance, screening for clinically significant portal hypertension, and consideration of non-selective beta blockers like carvedilol. This video offers practical insights for hepatology providers navigating the evolving MASLD landscape and highlights how early intervention and accurate staging can impact long-term outcomes.
Related Webcast
MASLD Basics With Suzanne Robertazzi
July 2025
Join Suzanne, a nurse practitioner from the Washington DC VA Medical Center, as she kicks off a comprehensive lecture series on steatotic liver disease, focusing on the evolving understanding of MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). In this foundational session, Suzanne walks through the new nomenclature replacing NAFLD and NASH, and outlines the clinical criteria used to identify and stratify patients along the MASLD–MASH spectrum. Learn how metabolic risk factors such as obesity, prediabetes, hypertension, and dyslipidemia contribute to disease progression, and explore the use of non-invasive diagnostic tools like Fib-4, FibroScan, and ELF scores to assess fibrosis. The session also discusses indications for liver biopsy, the implications of overlapping etiologies (like alcohol-associated liver disease), and strategies for identifying patients at high risk for cirrhosis, hepatocellular carcinoma (HCC), and liver-related mortality. This lecture equips clinicians, particularly those in primary care and hepatology, with a practical framework to evaluate steatosis, interpret metabolic profiles, and determine when to refer patients for specialty care. Whether you're new to liver disease or looking for updates on MASLD and MASH terminology, this session is an essential starting point.
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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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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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Non-Invasive Testing With Janet Gripshover
July 2025
In this in-depth and practical discussion, Janet Gripshover, NP from Cedars-Sinai in Los Angeles, explores the evolving role of non-invasive testing (NITs) in the diagnosis and risk stratification of MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). Drawing from real-world experience and a case study involving a 65-year-old patient with multiple cardiometabolic risk factors, she breaks down the latest 2025 approaches to fibrosis assessment—highlighting the use of FIB-4, ELF score, vibration-controlled transient elastography (FibroScan®), and MR elastography. Gryover also emphasizes how combining tests across modalities can improve accuracy and patient care while avoiding the risks of liver biopsy. Learn how liver stiffness, lab values, and clinical history all intersect to guide care and treatment decisions in patients with fatty liver disease. This session is part of the MASLD/MASH Community Network and is ideal for providers, specialists, and anyone interested in the forefront of liver disease management.
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Comparing F3 and F4 Fibrosis With Erin Tanner
July 2025
Join Erin Tanner, NP from Gastro Health in Birmingham, Alabama, for a practical and in-depth exploration of how to differentiate and manage patients with F3 versus F4 fibrosis in the setting of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH. This session, part of the MASLD & MASH Community Network, features two detailed case studies—Sam A and Sam B—who share identical comorbidities but diverge in fibrosis stage, illustrating how non-invasive testing (NITs) can guide diagnosis and treatment. Erin walks through the clinical application of tools like FIB-4, FibroScan (VCTE), ELF test, and CAP score, emphasizing the importance of interpreting lab and imaging results in context. The discussion covers key decision points, including when to initiate pharmacologic therapy like resmetirom (Rezdiffra), how to determine eligibility for HCC surveillance, and when to consider liver biopsy. She also addresses common challenges in community GI settings, such as incidental fatty liver findings, elevated ferritin levels, and the limitations of FIB-4 in older or diabetic patients. Whether you're in hepatology, gastroenterology, or primary care, this talk offers actionable insights on fibrosis staging, lifestyle counseling, and long-term monitoring in patients with MASLD and MASH.
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Non-Invasive Testing With Sherona Bau
July 2025
In this engaging and highly informative GHAPP MASLD Community Network session, Sherona Bau, PA-C, walks attendees through a practical overview of non-invasive testing (NIT) for evaluating liver health in patients with MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). Drawing on real-world clinical experience, Sherona explains why non-invasive testing is essential for identifying fibrosis risk in a population where liver steatosis is prevalent in up to 30% of U.S. adults. Through the case of a 65-year-old Hispanic male named Albert, Sherona demonstrates how to interpret and apply tools such as FIB-4, FibroScan (VCTE and CAP score), ELF (Enhanced Liver Fibrosis) test, and MR Elastography (MRE). She highlights their respective strengths, limitations, clinical cut-offs, and insurance-related considerations. The session also covers when to order tests, how to assess data quality (e.g., IQR/median ratio in VCTE), and when to escalate care to hepatology or cardiology. Whether you are a primary care provider, endocrinologist, or hepatology specialist, this talk delivers practical algorithms and decision-making pathways for managing MASLD, improving early detection of fibrosis and cirrhosis, and integrating cardiovascular risk assessment into liver care. Sherona also emphasizes the importance of alcohol use history, metabolic syndrome risk factors, and annual NIT follow-up in patients at risk for disease progression.
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Lifestyle Management With Christina Hanson
July 2025
Join Christina Hanson, NP from South Denver GI, for a practical and in-depth discussion on lifestyle management of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Steatohepatitis). In this GHAPP MASLD/MASH Community Network session, Christina walks through the case of Albert, a 65-year-old patient with obesity, diabetes, and abnormal liver findings—representing a common clinical scenario in primary and specialty care. This session highlights how to apply non-invasive fibrosis assessment tools like FIB-4 and FibroScan, interpret metabolic risk factors, and differentiate patients based on fibrosis staging. Christina discusses how cultural dietary habits, access to care, and social determinants of health impact disease management, and emphasizes the importance of personalized counseling, accountability strategies, and gradual, sustainable changes to diet and exercise. The session also reviews the role of Resmetirom, the first FDA-approved treatment for MASH with F2-F3 fibrosis, and outlines guideline-recommended lifestyle interventions including the Mediterranean diet and combined aerobic/resistance exercise. Learn how to identify, stage, and manage patients with MASLD and MASH in a way that supports long-term adherence and improves liver-related outcomes. Educational support provided by Madrigal Pharmaceuticals.
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MASLD Pharmacotherapy
July 2025
In this dynamic and highly informative session, Sherona Bau, NP, presents a comprehensive overview of pharmacotherapy in MASLD and MASH, breaking down current treatment strategies and emerging therapies for patients with metabolic dysfunction-associated steatotic liver disease. This presentation, part of the MASLD/MASH Community Network, begins by contextualizing the recent nomenclature shift from NAFLD/NASH to MASLD/MASH and its clinical implications. Sherona explores lifestyle intervention targets, including Mediterranean diet, weight loss goals based on fibrosis stage, and the role of GLP-1 and GIP receptor agonists in improving liver health. She highlights the ESSENCE trial results for semaglutide, discusses the only FDA-approved therapy to date—resmetirom (Rezdiffra)—and explains its mechanism of action via thyroid hormone receptor beta activation. The session dives deep into efficacy data from the MAESTRO-NASH trial, side effect profiles, drug–drug interactions, and monitoring recommendations. She also previews a pipeline of promising agents in phase 2 and 3 trials—including tirzepatide (GLP-1/GIP), cotadutide (GLP-1/GR), pemvidutide (GLP-1/GIP), and retatrutide (GLP-1/GIP/GR)—offering insight into what’s next in the evolving treatment landscape. This is a must-watch for hepatology and endocrinology clinicians focused on the future of fatty liver management.
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Comparing F3 and F4 Fibrosis With Edith Johannes
July 2025
Join Edith Johannes, NP from UCLA Health, for a comprehensive and approachable introduction to MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease)—formerly known as NAFLD—and how to accurately diagnose it. Designed for primary care providers and early learners in hepatology, this session outlines the fundamental criteria for diagnosing MASLD and MASH, the importance of ruling out alternate causes of hepatic steatosis, and the key role of cardio-metabolic risk factors. Edith discusses how to apply non-invasive testing tools such as the FIB-4 score, ELF test, and elastography to determine fibrosis stage, along with guidance on when to consider liver biopsy and refer to hepatology. The presentation also explores the overlap between MASLD and alcohol-related liver disease, addresses the impact of genetic risk factors like PNPLA3 (particularly in Hispanic populations), and reinforces the urgent need for early detection to prevent cirrhosis and liver cancer. With clinical pearls and case-based examples, this session helps clinicians feel confident in evaluating patients for MASLD and navigating next steps for care.
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Lifestyle Management With Michelle Barnett
July 2025
Join Michelle Barnett, PA-C, for an in-depth clinical case presentation as part of the GHAPP MASLD Community Network. With over 25 years of experience in GI and hepatology, Michelle walks through the real-world management of Albert, a 65-year-old patient newly diagnosed with MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease). In this session, she outlines key diagnostic criteria, the role of non-invasive tests (NITs) like FIB-4 and FibroScan, and how to risk-stratify patients using updated care pathways. Learn how to differentiate low-, moderate-, and high-risk cases and when to refer for hepatology evaluation or consider biopsy. Michelle also explores the clinical role of Resmetirom—the first FDA-approved medication for patients with MASH and F2-F3 fibrosis—and emphasizes the importance of sustained lifestyle modification, dietary change, and exercise in liver disease management. This expert discussion includes cultural and socioeconomic considerations, adherence strategies, and patient tools like the Exercise and Diet Adherence Scale. Visit the GHAPP MASLD Community Network for more resources, disease-state education, and updates on the evolving care landscape. Educational content supported by Madrigal Pharmaceuticals.
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