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August 2025
In this educational session, Jessica Crimaldi, a nurse practitioner at Cleveland Clinic with nearly a decade of experience in gastroenterology and hepatology, walks through real-world cases comparing patients with F3 fibrosis and F4 fibrosis. She reviews how to assess disease severity using non-invasive tests like FIB-4, FibroScan, CAP scores, and ELF tests, and explains how clinical findings such as platelets, bilirubin, and INR can guide staging. Jessica highlights the differences in management between patients with advanced fibrosis versus cirrhosis, including the role of lifestyle modifications, GLP-1 therapy, statins, blood pressure control, and Resmetirom for eligible F2/F3 patients. She also discusses the importance of HCC surveillance, portal hypertension evaluation, esophageal varices screening, and long-term monitoring in cirrhosis care. This case-based learning approach offers practical insights into fatty liver disease, MASLD/MASH progression, and optimizing patient outcomes through accurate staging and tailored treatment strategies.
Related Podcast
Comparing F3 and F4 Fibrosis With Christie Morrison
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.
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Common Questions From Primary Care Providers About MASH
July 2025
In this concise and practical discussion, Lindsay Pratt, PA-C from the University of Colorado’s Department of Hepatology and Liver Transplant, shares expert guidance on screening and managing patients with MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). Speaking directly to the common questions she receives from primary care providers, Lindsay outlines when to screen for MASLD/MASH—emphasizing the importance of evaluating patients with elevated liver enzymes, hepatic steatosis on imaging, and cardiometabolic risk factors like diabetes, hypertension, hyperlipidemia, and sleep apnea. She breaks down the utility of FIB-4 as a first-line non-invasive test, when to use FibroScan®, and clears up a common misconception about statin use in liver disease—encouraging providers to continue or initiate statins when indicated. This session is ideal for clinicians managing metabolic syndrome and its liver manifestations and offers simple, evidence-based tools to identify at-risk patients early.
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Addressing Health Disparities: Equity Considerations in MASH/MASLD Care
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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Podcast: PCP Screening for MASH/MASLD: Identifying At-Risk Patients
July 2025
In this essential podcast episode from the GHAPP MASLD/MASH Community Network, Summer Collier, NP at UC San Diego Health, dives into the critical role that primary care providers and advanced practice providers play in recognizing and managing MASLD (Metabolic dysfunction-associated steatotic liver disease) and its progressive form, MASH (Metabolic-associated steatohepatitis). With MASLD affecting a growing number of patients—many undiagnosed—Summer walks through practical strategies for early identification, starting with high-risk individuals such as those with type 2 diabetes, obesity, or metabolic syndrome. She highlights the use of the FIB-4 index as a quick, validated, and guideline-recommended first-line screening tool, and explains how to interpret FIB-4 results to stratify risk and determine next steps, including ELF testing, FibroScan®, or referral to GI/hepatology. Summer also offers actionable workflow tips to integrate liver screening into routine primary care, like embedding FIB-4 calculators in EMRs or incorporating assessments into annual diabetes visits. This episode is a must-listen for clinicians seeking to prevent liver fibrosis progression and liver cancer through early, proactive care.
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MASLD vs MetALD With Christie Morrison
September 2025
In this MASLD Community Network session, Christie Morrison, NP, shares a practical case study to explain how to recognize and manage metabolic dysfunction–associated steatotic liver disease (MASLD), MASH, and mixed-etiology MET-ALD. She highlights how common risk factors like obesity, diabetes, high blood pressure, and regular alcohol use can overlap and accelerate liver damage. Christy also discusses how non-invasive testing helps stage disease, why accurate alcohol history is important, and what steps providers can take to support patients. Lifestyle changes such as adopting a healthier diet, increasing physical activity, losing weight, and reducing alcohol intake remain the foundation of care. This overview is designed for APPs and GI clinicians looking for clear, practical strategies to help patients prevent progression to advanced liver disease.
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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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MASLD Pharmacotherapy With Jeremy Davis
September 2025
In this clinician-focused talk, Jeremy Davis, NP, delivers a clear, practical guide to MASLD/MASH pharmacotherapy—from foundational lifestyle and weight-loss strategies to medications that move the needle. He reviews the role of GLP-1 receptor agonists (and emerging dual agonists) for weight reduction and glycemic control, peri-procedure considerations (delayed gastric emptying/aspiration risk), and where legacy options like vitamin E (select non-diabetic, non-cirrhotic patients) and pioglitazone fit, including benefits and safety trade-offs. The session spotlights resmetirom—the first FDA-approved, liver-directed THR-β agonist for non-cirrhotic MASH with F2–F3 fibrosis—covering its mechanism, key MAESTRO-NASH data, common AEs (nausea/diarrhea), and practical drug–drug interaction/statin-dosing considerations. You’ll also learn how to structure follow-up with non-invasive testing (FibroScan kPa/CAP, ELF, labs), set measurable lifestyle goals, coordinate cardiometabolic risk reduction (T2D, hypertension, dyslipidemia), and navigate coverage and duration questions—so you can confidently tailor therapy and improve outcomes across the MASLD/MASH spectrum.
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LFTs Demystified: A practical guide for APPs
July 2025
In this GHAPP MASLD Community Network podcast, Jessica Crimaldi, NP, from the Cleveland Clinic, provides practical, real-world insights into interpreting liver function tests (LFTs) in the context of MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH (steatohepatitis). Drawing on over a decade of experience in GI and hepatology, Jessica explains common ALT and AST elevation patterns that should prompt a diagnostic workup, even in asymptomatic patients. She reviews the hepatocellular vs. cholestatic patterns of injury, the value of the R-factor calculator in identifying the likely etiology of liver enzyme abnormalities, and how to differentiate MASH from other liver diseases such as PBC, viral hepatitis, or bile duct obstruction. The episode also addresses key non-liver labs like triglycerides, A1C, and cholesterol, and how they contribute to assessing metabolic risk. Finally, Jessica discusses the role of serial LFT monitoring in evaluating treatment response—highlighting what it means when liver enzyme levels fall and why "normal" LFTs don’t always indicate disease resolution. Whether you're a primary care provider or hepatology specialist, this podcast offers valuable guidance for early detection, risk stratification, and longitudinal monitoring of patients with MASH.
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MASLD vs MetALD With Summer Collier
September 2025
In this educational session from the GHAPP MASLD Community Network, Summer Collier, NP at UC San Diego Health, explores the overlap between metabolic dysfunction–associated steatotic liver disease (MASLD) and metabolic dysfunction plus alcohol-associated liver disease (MetALD) through a detailed clinical case study. Using real-world patient data, she highlights key considerations for evaluating, diagnosing, and managing steatotic liver disease, with special focus on teasing out the dual drivers of metabolic risk factors and alcohol consumption. Viewers will learn about diagnostic tools such as FibroScan, CAP scores, and PEth testing, and how these objective biomarkers help distinguish true MASLD from alcohol-driven disease. The discussion also covers pathophysiology, risk of fibrosis progression, patient counseling on lifestyle and alcohol cessation, current treatment recommendations, and hepatocellular carcinoma (HCC) screening in advanced fibrosis. Whether you are a hepatology provider, APP, or clinician interested in MASLD and MetALD, this session provides practical insights into patient education, disease classification, and the importance of standardized definitions for clinical care and research.
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Lifestyle Management With Milly Ng
August 2025
Join Milly Ng, NP, a hepatology nurse practitioner at Tufts Medical Center in Boston, for an evidence-based session on lifestyle management for MASLD and MASH, presented through the GHAPP MASLD Community Network and sponsored by Madrigal Pharmaceuticals. Through the case of "Albert," a patient with steatosis and metabolic risk factors, Milly highlights the importance of personalized counseling and non-invasive testing like FIB-4 and FibroScan to assess fibrosis risk. She reviews how Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and its progressive form, MASH, can be reversed through diet, exercise, and weight loss, particularly before fibrosis advances to cirrhosis. Learn how to tailor dietary guidance to a patient's cultural background, socioeconomic status, and personal goals, and understand how central obesity and insulin resistance drive disease progression. Milly also reviews the genetic and environmental factors influencing steatosis, why aerobic training may be more effective than resistance workouts for liver health, and how validated tools like the EDAS (Exercise and Diet Adherence Scale) can track patient progress. This session empowers primary care and hepatology providers to deliver patient-centered lifestyle interventions that can prevent liver disease progression and reduce cardiometabolic risk.
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