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August 2025
Join Jessica Crimaldi, NP, from the Cleveland Clinic, for an in-depth and practical overview of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease), presented through the GHAPP MASLD Community Network and supported by Madrigal Pharmaceuticals. In this foundational session, Jessica breaks down the new 2023 steatotic liver disease nomenclature, replacing NAFLD and NASH with MASLD and MASH, and explains how these changes align with updated AASLD guidelines. Through a case-based approach, she walks through key diagnostic criteria, highlighting the role of cardiometabolic risk factors, non-invasive assessments such as FIB-4, FibroScan, and ELF, and when to consider liver biopsy for staging fibrosis. Learn how to stratify patients based on metabolic profiles, evaluate imaging and lab results, and identify those at risk for progression to advanced fibrosis or cirrhosis. Jessica also discusses global epidemiology, genetics (like PNPLA3), environmental contributors, and the clinical importance of early detection. With a comprehensive workup strategy for primary care and GI settings, this session equips providers to implement guideline-driven MASLD evaluation and referral practices for improved patient outcomes.
Related Podcast
Comparing F3 and F4 Fibrosis With Erin Parkinson
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.
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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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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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Non-Invasive Testing With Elizabeth Alqueza
August 2025
In this session, Elizabeth Alqueza, PA-C at Beth Israel Deaconess Medical Center, provides a comprehensive overview of non-invasive testing in patients with Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and MASH. Using a real clinical case, she explains how to evaluate patients with abnormal liver enzymes and steatosis on imaging, and how to apply widely used tools such as the FIB-4 score, ELF test, FibroScan (VCTE), CAP score, shear wave elastography, and MR elastography. Elizabeth highlights the strengths, limitations, and interpretation of each test, along with practical considerations like cost, accessibility, patient factors, and operator experience. She also reviews the MASLD care pathway, emphasizing how accurate staging with non-invasive tests helps identify at-risk patients with advanced fibrosis who need closer monitoring, lifestyle interventions, and specialty referral. This talk underscores the critical role of non-invasive assessment in preventing progression to cirrhosis, liver failure, and hepatocellular carcinoma.
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Lifestyle Management With Sarah Dawkins
August 2025
Join Sarah Dawkins, NP, for an in-depth and inspiring conversation on lifestyle management for MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction-Associated Steatohepatitis), presented through the GHAPP MASLD Community Network and sponsored by Madrigal Pharmaceuticals. In this engaging session, Sarah uses the real-world case of "Albert" to explore how to assess fibrosis risk using non-invasive testing like FIB-4 and FibroScan, and why lifestyle interventions remain the cornerstone of care for patients without advanced fibrosis. Through a patient-centered lens, she outlines practical strategies for addressing dietary counseling, exercise goals, and culturally sensitive approaches to nutrition—highlighting how individualized care, family involvement, and positive reinforcement can create meaningful behavior change. The session dives into the science behind genetic risk factors like PNPLA3, the role of central obesity in inflammation, and the impact of Western diets on liver health. Sarah also reviews the Mediterranean diet, exercise recommendations, and evidence-based interventions, including the benefits of aerobic + resistance training over HIIT for MASLD improvement. With clinical pearls on motivational interviewing, overcoming barriers to access, and the use of tools like the Exercise and Diet Adherence Scale (EDAS), this session empowers providers to make lifestyle conversations impactful—even when time is short.
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Lifestyle Management With Jonathan Yeh
August 2025
In this GHAPP MASLD Community Network session, Jonathan Yeh, PA-C from Columbia University Irving Medical Center, presents a case-based discussion on the lifestyle management of MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). Through the case of a 65-year-old patient with obesity, type 2 diabetes, hypertension, and hyperlipidemia, Jonathan highlights how dietary modification, weight loss, and physical activity remain the foundation of treatment, even with new pharmacotherapies available. The presentation emphasizes the benefits of the Mediterranean diet, the importance of avoiding refined carbohydrates, and the role of both aerobic and resistance exercise in improving liver health, reducing steatosis, and potentially reversing fibrosis. Cultural considerations, patient adherence challenges, and strategies to drive behavior change are also addressed, providing clinicians with practical insights to support patients in preventing progression to advanced fibrosis or cirrhosis.
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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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Podcast: Viral Hepatitis and MASH/MASLD: Understanding the Connection
June 2025
In this episode, Patrick Horne, NP from the University of Florida, explores the important connection between viral hepatitis and MASLD/MASH (Metabolic Dysfunction–Associated Steatotic Liver Disease/Steatohepatitis). While patients may present with a presumed diagnosis of MASLD or MASH, Patrick emphasizes the critical need to rule out coexisting liver diseases such as hepatitis B and C. The presence of both metabolic and viral liver diseases can significantly accelerate liver inflammation, fibrosis progression, and ultimately cirrhosis—a concept he explains using the “two-hit” or even “three-hit” theory. Patrick walks through the recommended screening protocols, including one-time HCV testing for all adults over 18 and complete HBV panels to assess for immunity, past exposure, and chronic infection. He stresses that treating viral hepatitis—especially with today's highly effective antivirals—can and should occur alongside lifestyle modification strategies for MASLD/MASH. He also discusses how liver stiffness measurements can be skewed by active inflammation and suggests reassessing fibrosis after treating viral hepatitis. This episode is a must-watch for providers managing patients with liver disease, highlighting the need for a comprehensive, layered diagnostic approach.
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Comparing F3 and F4 Fibrosis With Robin Soto
July 2025
In this in-depth case-based session from the GHAPP MASLD/MASH Community Network, Robin Soto, NP from UC San Diego Health, explores the clinical nuances of diagnosing and managing fibrosis stage 3 versus stage 4 in patients with MASH (Metabolic Dysfunction–Associated Steatohepatitis). Using a real-world case study of a patient named Sam, Robin demonstrates how to interpret and reconcile non-invasive tests (NITs) like FIB-4, FibroScan, CAP score, and ELF test to guide accurate staging. She offers practical insights into treatment decisions, including when to use resmetirom, the importance of lifestyle modification, and how to assess comorbidities like diabetes, obesity, and cardiovascular risk. The session also outlines when and how to monitor for hepatocellular carcinoma (HCC), implement liver cancer surveillance strategies, and approach multidisciplinary care for advanced fibrosis or cirrhosis. Whether you’re a hepatology specialist or a primary care provider, this video equips you with evidence-based tools for managing MASLD and optimizing outcomes in complex liver disease.
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PCP Screening for MASH/MASLD: Identifying At-Risk Patients
August 2025
Join Tessa Janovsky, PA-C from Arizona Liver Health, for a practical and guideline-based discussion on screening for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH) in primary care. This session outlines which patient populations Advanced Practice Providers (APPs) should routinely screen—such as individuals with type 2 diabetes, medically complicated obesity, metabolic risk factors with fatty liver on imaging, moderate alcohol use (MetALD), or a family history of MASH cirrhosis. Learn how to apply first-line non-invasive screening tools like FIB-4 and the NAFLD Fibrosis Score, understand their limitations, and incorporate them into busy clinic workflows. Tessa shares strategies for communicating positive results to patients, next steps for further evaluation (ELF test, FibroScan, MRI elastography), and criteria for timely referral to gastroenterology or hepatology. With practical tips for integrating MASLD/MASH screening into electronic medical records, building clinical pathways, and standardizing protocols, this episode equips PCPs and specialists to detect high-risk patients earlier, intervene effectively, and ultimately improve liver health outcomes.
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