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MASLD AI 10:34 AM
August 2025
Join Maribeth Capuno, DNP, from the Richmond VA Medical Center, for an insightful case-based discussion on F3 vs. F4 fibrosis staging in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH, presented through the GHAPP MASLD/MASH Community Network and sponsored by Madrigal Pharmaceuticals. Using the fictional case of “Sam,” Maribeth demonstrates how to differentiate between F3 and F4 fibrosis using non-invasive tools like FIB-4, FibroScan, and the ELF test, while explaining their respective cutoffs and clinical implications. Learn how to stage MASLD accurately, when to consider MRI elastography or liver biopsy, and how to initiate evidence-based management strategies including lifestyle modification, GLP-1 therapy, and the newly approved medication Resmetirom (Rezdiffra). The session highlights the importance of HCC surveillance, portal hypertension screening, and the nuances in monitoring between F3 and F4 fibrosis stages. With a strong emphasis on practical, guideline-aligned hepatology care, this video provides essential insights for clinicians managing the growing MASLD population.
Related Podcast
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 Ellie Gonyeau
September 2025
In this practical, clinician-focused talk, Ellie Gonyeau, NP, walks through a streamlined pharmacotherapy framework for MASLD/MASH—anchored on three pillars: obesity management, cardiometabolic risk reduction (T2D, hypertension, dyslipidemia), and liver-directed therapy. She reviews where GLP-1 receptor agonists fit (weight loss, glycemic control, peri-procedure considerations), summarizes evidence and patient selection for high-dose vitamin E and pioglitazone, and explains the role of resmetirom—the first FDA-approved therapy for non-cirrhotic MASH with F2–F3 fibrosis—its liver-selective THR-β mechanism, pivotal trial outcomes, common AEs, and drug-interaction/ statin considerations. You’ll also learn how to monitor and restage using non-invasive tests (FibroScan kPa/CAP, ELF, labs), set measurable lifestyle goals, and navigate real-world questions around coverage, testing cadence, and treatment duration—so you can confidently tailor therapy and improve outcomes for patients across the MASLD/MASH spectrum.
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Podcast: Pharmacotherapy for MASH/MASLD: An Overview
June 2025
In this comprehensive episode, Christina Hanson, FNP-C at South Denver GI, provides an in-depth overview of pharmacotherapy for MASLD and MASH, with a focus on the FDA-approved therapy resmetirom (brand name Rezdiffra). Drawing on over 18 years of experience in hepatology and GI care, Christina explains the histologic endpoints used in clinical trials—MASH resolution and fibrosis improvement without worsening disease—and how they guided the approval of resmetirom. She breaks down the drug’s mechanism of action as a selective thyroid hormone receptor beta (THR-β) agonist, which promotes lipid metabolism and reduces liver inflammation without systemic toxicity. Christina reviews key Phase 3 data from the MAESTRO-NASH trial, showing resmetirom’s significant impact on both MASH resolution and fibrosis regression across diverse patient populations. She also outlines criteria for appropriate patient selection (those with stage F2-F3 fibrosis), clinical monitoring strategies, and management of side effects like transient GI discomfort. Christina emphasizes the importance of baseline screening for liver disease, autoimmune conditions, thyroid function, and lipid levels before initiating therapy. She highlights best practices from the 2024 AASLD guidelines for ongoing monitoring and treatment response assessment, including ALT and liver stiffness thresholds that help determine whether to continue or discontinue therapy. This episode is a must-watch for hepatology clinicians looking to implement evidence-based, patient-centered strategies in the management of MASH.
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MASLD Pharmacotherapy With Summer Collier
September 2025
Join Summer Collier, NP for a clear, clinic-ready overview of MASLD pharmacotherapy. This session explains why management starts with the metabolic syndrome—targeting obesity, type 2 diabetes, hypertension, and dyslipidemia—while reinforcing that lifestyle change (diet, physical activity, and 7–10% weight loss) remains the cornerstone. Summer reviews the role of GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) for weight reduction and glycemic control—including the anesthesia precaution to hold GLP-1 therapy 7 days before endoscopic procedures—and outlines liver-directed options: vitamin E (select non-diabetic patients, risks/limits), pioglitazone (cardiometabolic benefits vs. weight gain/edema considerations), and the first FDA-approved therapy for non-cirrhotic MASH with F2–F3 fibrosis, resmetirom (THR-β agonist targeting hepatic fat and inflammation). You’ll also hear practical tips on patient selection, staging and restaging with noninvasive tests (FIB-4, FibroScan®/elastography, MRI-PDFF, ELF), coordinating weight-management referrals, and planning follow-up. Ideal for GI/hepatology clinicians and APPs seeking an up-to-date, evidence-based roadmap to treat fatty liver disease and prevent progression to advanced fibrosis.
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Common Questions From Primary Care Providers About MASH
August 2025
In this MASLD Community Network episode, Edith Johannes, NP at UCLA Health, shares evidence-based guidance on one of the most important questions in managing Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction–Associated Steatohepatitis (MASH): how much weight loss is needed to improve liver health. Drawing on years of experience in hepatology and liver transplant care, Edith explains how weight loss can reduce liver fat (steatosis), decrease inflammation, improve or even reverse fibrosis, and support better overall metabolic health. Research shows that achieving more than 10% weight loss can result in 100% improvement in steatosis, MASH resolution in 90% of patients, and fibrosis regression in over 80%. Even smaller amounts of weight loss—5% to 10%—provide significant liver and metabolic benefits, while exercise and dietary changes can help improve liver function even without weight loss. Edith also discusses when additional treatments like GLP-1s, bariatric surgery, or resmetirom may be needed. This video is essential for healthcare providers, patients, and caregivers seeking practical, science-backed strategies to manage MASLD and MASH effectively.
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MASLD Pharmacotherapy With Jill Olmstead
September 2025
Join Jill Olmstead, DNP from Providence Health for a practical, clinician-focused overview of MASLD pharmacotherapy and new treatment horizons for hepatic steatosis. This session in the GHAPP MASLD & MASH Community Network covers the shift in nomenclature, why care must be multidisciplinary (obesity, type 2 diabetes, dyslipidemia, hypertension, cardiovascular risk), and how to stage disease with FIB-4, noninvasive tests, and FibroScan before initiating therapy. Jill reviews lifestyle and weight-loss strategies, GLP-1 receptor agonists—their mechanisms, common GI side effects, and peri-procedure considerations due to delayed gastric emptying—plus where vitamin E and pioglitazone do and don’t fit today. She also walks through practical use of resmetirom for non-cirrhotic MASH with F2–F3 fibrosis (labs to order, monitoring, drug–drug interactions, and setting expectations alongside diet and exercise). If you’re a GI/hepatology clinician, APP, or primary-care partner looking to streamline risk reduction, staging, and evidence-based therapy for MASLD/MASH, this talk delivers step-by-step guidance you can use in clinic today.
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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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Podcast: Pharmacotherapy for MASH/MASLD: An Overview
June 2025
In this informative episode, Lindsay Yoder, PA, a hepatology expert at Indiana University, provides a comprehensive overview of current pharmacotherapy options for MASH (Metabolic Dysfunction–Associated Steatohepatitis), focusing on the first FDA-approved medication, resmetirom (brand name: Rezdiffra). Speaking directly to the MASLD/MASH Community Network, Lindsay breaks down the key histologic endpoints that led to resmetirom’s conditional approval—namely, fibrosis improvement without worsening of steatohepatitis, and MASH resolution without worsening fibrosis. She shares real-world data from clinical trials showing that resmetirom nearly doubles the rate of fibrosis improvement and triples MASH resolution compared to placebo. Lindsay also explains how the drug works: as a thyroid hormone receptor beta agonist, resmetirom improves hepatic lipid metabolism, reduces liver fat, and dampens inflammation—all key drivers of MASH progression. She outlines ideal patient criteria (stage F2–F3 fibrosis without cirrhosis), safety considerations, tolerability, potential side effects, and statin interactions. With an emphasis on combining pharmacotherapy with lifestyle changes, this episode serves as a practical guide for clinicians treating patients with MASH who qualify for advanced intervention.
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Comparing F3 and F4 Fibrosis With Oyin Penny
August 2025
Understanding the differences between F3 and F4 fibrosis is crucial in the management of MASH (Metabolic Associated Steatohepatitis) and other liver diseases. In this session with Oyin Penny, FNP, from the GHAPP MASLD Community Network, we explore a case-based comparison using non-invasive tests (NITs), including FibroScan, ELF score, and Fib-4, to highlight how staging impacts prognosis, treatment strategies, and long-term outcomes. Case 6A focuses on a patient with F3 fibrosis, discussing lifestyle modification, metabolic disease optimization, and the role of therapies like Resmetirom (Rezdiffra). Case 6B revisits the same patient profile but with F4 fibrosis, emphasizing advanced management including HCC surveillance, EGD screening for varices, and consideration of non-selective beta blockers. By contrasting these scenarios, this presentation underscores the importance of accurate fibrosis staging, risk stratification, and timely interventions to improve patient outcomes.
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Non-Invasive Testing With April Morris
July 2025
In this educational presentation, April Morris, FNP—an experienced provider in both liver disease and endocrinology—guides viewers through the evolving landscape of non-invasive testing (NITs) for diagnosing and managing patients with MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH. Using the case of a 65-year-old male with metabolic co-morbidities and suspected liver disease, Morris reviews how to effectively apply tools like the FIB-4 score, ELF test, and FibroScan (VCTE) to assess fibrosis risk and stratify patients. She compares imaging modalities including transient elastography, MR elastography (MRE), and shear wave elastography, offering practical considerations such as patient eligibility, test accuracy, and insurance barriers. The discussion emphasizes the importance of interpreting NITs within clinical context—highlighting how to determine risk, guide patient counseling, and establish a follow-up plan for low-risk patients. This session also reinforces the role of primary care in longitudinal liver health management and directs providers to resources available through the GHAPP MASLD & MASH Community Network.
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