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MASLD AI 03:45 AM
September 2025
In this MASLD Community Network talk, Lavinia Iordache, PA, walks through a real-world case to show how to accurately identify advanced liver fibrosis and, critically, how to distinguish F3 vs F4—a difference that drives management, eligibility for resmetirom (Rezdiffra), and surveillance strategy. She demonstrates a stepwise use of non-invasive tests (NITs)—FIB-4, FibroScan/VCTE with kPa and CAP, ELF serum biomarkers, and when to add MRE or biopsy—plus how to handle discordant/indeterminate results. The session covers cardiometabolic risk factors, lab patterns, and practical monitoring tips, including HCC surveillance considerations (modality choice in obesity, AFP/AFP-L3) and portal-hypertension cues that trigger EGD for varices. You’ll leave with a clear algorithm to stage disease, personalize treatment, and avoid missing F3 candidates who may otherwise be excluded by FIB-4 alone.
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MASLD Basics With Jessica Crimaldi
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.
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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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MASLD Pharmacotherapy With Anthony Derencius
August 2025
Join Anthony Derencius, PA-C, sub-investigator at Pinnacle Clinical Research, for an in-depth, case-based discussion on the pharmacologic management of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Steatohepatitis) in this GHAPP MASLD Community Network presentation. With clinical insights from both hepatology practice and research, Anthony explores the multifactorial approach to managing metabolic liver disease—emphasizing weight loss strategies, GLP-1 receptor agonists, cardiovascular risk reduction, and liver-directed therapies. Learn how medications like semaglutide and tirzepatide play a role in weight loss and glycemic control, and how vitamin E and pioglitazone are still considered under specific circumstances. A major highlight includes the mechanism and clinical data behind resmetirom, the first FDA-approved therapy for MASH with F2–F3 fibrosis. Anthony explains its thyroid hormone receptor β-selectivity, efficacy data from the MAESTRO-NASH trial, real-world safety considerations, drug interactions, and monitoring protocols. This presentation is essential viewing for clinicians managing MASLD and MASH in both community and research settings, offering practical strategies, current guidelines, and a look into the future of liver-specific pharmacotherapy.
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MASLD vs MetALD With Christina Hanson
September 2025
Discover the latest insights on MASLD and MetALD in this educational session from the GHAPP MASLD Community Network. Christina Hanson, FNP-C, walks through a real-world case study to highlight how common metabolic conditions like hypertension, hyperlipidemia, obesity, and PCOS intersect with alcohol use to drive liver disease progression. The session explores updated nomenclature replacing NAFLD/NASH, the role of FibroScan and elastography in staging fibrosis, and the importance of screening patients with metabolic risk factors for fatty liver. Learn how alcohol consumption contributes to liver injury, triglyceride elevation, and blood pressure changes, and how objective biomarkers such as PEth testing are transforming diagnosis beyond self-reporting. Christina also reviews lifestyle interventions, dietary strategies like the Mediterranean diet, and current treatment considerations for patients with advanced fibrosis (stage 3), including when to initiate HCC screening. Whether you are a hepatologist, GI specialist, or advanced practice provider, this session provides practical tools for evaluating and managing patients with MASLD, MetALD, and related liver health challenges.
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Lifestyle Management With Lisa Richards
July 2025
Join Lisa Richards, FNP-BC, from UC San Diego Health, as she leads a powerful educational session on the lifestyle management of MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) in this GHAPP MASLD/MASH Community Network event, sponsored by Madrigal Pharmaceuticals. Through a compelling clinical case study, Lisa walks viewers through a step-by-step approach to diagnosing MASLD, assessing fibrosis risk using noninvasive tools like FIB-4 and FibroScan, and implementing guideline-based interventions. Learn how to counsel patients on culturally sensitive dietary modifications, physical activity strategies, and behavior change techniques that improve outcomes. This session also explores the clinical relevance of weight loss thresholds, Mediterranean-style eating plans, and the importance of patient-centered goal setting. Whether you’re a provider managing metabolic liver disease or looking to integrate newer therapies like resmetirom, this video offers practical tools to empower sustainable change and improve liver health.
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Non-Invasive Testing With Kelly Smeester
August 2025
Join Kelly Smeester, MMS, RD, PA-C, from South Denver Gastroenterology, for an in-depth discussion on the latest tools and strategies in non-invasive liver disease assessment, presented through the GHAPP MASLD Community Network. This evidence-based session walks viewers through a case study of a patient with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and explores the full range of non-invasive testing modalities used to evaluate liver fat, stiffness, and fibrosis risk. Kelly breaks down the utility of key tests including FIB-4, ELF Score, FibroScan (VCTE), and MR Elastography, and compares their accuracy, accessibility, limitations, and clinical value. Learn how to interpret biomarkers such as CAP (Controlled Attenuation Parameter) and kPa (Kilopascals), how to navigate indeterminate FIB-4 results, and when to escalate to more advanced imaging like MRE. The session also provides insights into combined scoring models (FAST, MAST, MEFIB), real-world use cases, and how comorbidities and patient-specific factors (BMI, ALT, bilirubin, ascites) can impact test reliability. Whether you're managing early-stage fatty liver disease or advanced fibrosis, this session provides essential knowledge to guide accurate diagnosis, risk stratification, and long-term monitoring without a liver biopsy.
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APP Insight: Common Questions from Patients About MASH
June 2025
In this video, Jonathan Yeh, PA, answers three of the most frequently asked questions about MASH—Metabolic Dysfunction–Associated Steatohepatitis—and offers practical advice for understanding and managing this progressive form of fatty liver disease. He begins by explaining what MASH is: an inflammatory, more advanced stage of MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease), driven by abnormal fat accumulation in the liver due to impaired fat transport. Jonathan then breaks down the treatment approach, emphasizing the importance of lifestyle modification—particularly diet and exercise. He highlights the benefits of a green Mediterranean diet, regular physical activity, and sustainable weight loss, which can improve or even reverse MASH in many patients. For individuals with more advanced fibrosis, pharmacologic treatment with resmetirom (Rezdiffra) may be indicated. This concise FAQ offers helpful guidance for patients and providers alike on tackling MASH with evidence-based strategies.
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Common Questions From Primary Care Providers About MASH
August 2025
Join Maly Tiev, NP, NYU Langone Health, as she answers common questions from primary care providers about Metabolic Dysfunction-Associated Steatohepatitis (MASH). Learn who should be screened based on AASLD and American Diabetes Association guidelines, including patients with obesity, pre-diabetes or diabetes, metabolic syndrome, persistent ALT elevation, or steatosis on imaging. Molly explains when to refer MASH patients to gastroenterology or hepatology—such as those with FIB-4 scores over 1.3, suspected advanced fibrosis, or unexplained liver enzyme elevations—and addresses the safety of prescribing statins in MASH. Backed by multiple studies, she emphasizes that statins do not increase liver injury risk and can significantly reduce cardiovascular mortality, the leading cause of death in this population. This session provides practical, evidence-based guidance to help clinicians improve MASH detection, optimize referrals, and manage cardiovascular risk safely.
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Common Questions From Community GI About MASH With Maribeth Capuno
September 2025
In this educational session, Maribeth Capuno, Adult Nurse Practitioner specializing in hepatology at the Richmond VA Medical Center, answers two of the most common questions clinicians face about Metabolic Associated Steatotic Liver Disease (MASLD) and Metabolic Associated Steatohepatitis (MASH). She explains how elevated liver enzymes—particularly when ALT is greater than AST—can be an early signal to investigate further, and why obtaining a baseline ultrasound and, when possible, a FibroScan are key steps in assessing liver health. Maribeth also covers how to determine the right time to repeat non-invasive liver testing, especially in patients with higher-risk metabolic conditions such as diabetes, and highlights the role of tests like Fib-4 and the ELF test in identifying fibrosis risk. Whether you’re a healthcare provider managing patients with liver disease or someone seeking to understand the latest non-invasive approaches to MASLD and MASH, this video provides practical guidance on monitoring, testing frequency, and risk assessment strategies that can improve patient care and outcomes.
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Non-Invasive Testing With Erin Tanner
July 2025
In this educational session from the GHAPP MASLD & MASH Community Network, Erin Tanner, PA-C from Gastro Health in Birmingham, Alabama, presents a practical overview of non-invasive testing (NIT) options for evaluating and managing MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). Using a patient case study, Erin explores how clinicians can effectively utilize tools like FIB-4, FibroScan® (VCTE and CAP), ELF, MRE, and other emerging imaging and serum biomarkers to assess hepatic steatosis and fibrosis without the need for liver biopsy. The talk breaks down the pros, cons, and clinical accuracy of various NITs—including shear wave elastography, MRI-PDFF, and proprietary serum markers—and offers guidance on how to apply these tools in real-world hepatology and primary care settings. Special attention is given to identifying patients with metabolic risk factors, interpreting indeterminate FIB-4 scores, and knowing when to refer patients for further hepatology evaluation. Whether you’re new to liver disease management or looking to update your MASLD/MASH care pathways, this session offers clarity on how to stratify fibrosis risk and make informed clinical decisions using non-invasive diagnostics.
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