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September 2025
In this educational session from the MASLD Community Network, Sarah Dawkins, NP, from Duke University Medical Center, explores the critical differences between F3 and F4 fibrosis in patients with MASLD and MASH. Through real patient case studies, she highlights how non-invasive testing methods—such as FIB-4, FibroScan, ELF testing, and imaging—play a vital role in accurately staging fibrosis and guiding treatment decisions. The discussion also covers the impact of metabolic risk factors like type 2 diabetes, obesity, and hypertension, along with strategies for management that include lifestyle modifications, weight loss goals, GLP-1 therapy, and the use of resmetirom (Rezdiffra) for eligible patients. Sarah emphasizes the importance of HCC surveillance, esophageal varices screening, and ongoing monitoring to improve outcomes for patients with advanced liver disease. This session underscores why distinguishing between F3 and F4 fibrosis is essential in clinical practice and how non-invasive testing can support timely diagnosis, treatment, and long-term care planning.
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MASLD Pharmacotherapy With Elizabeth Alqueza
August 2025
In this presentation, Elizabeth Alqueza, PA at Beth Israel Deaconess Medical Center, provides a comprehensive overview of pharmacotherapy for Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and MASH. She highlights the latest treatment strategies, including lifestyle modifications, cardiovascular risk reduction, and targeted liver-directed therapies. Elizabeth reviews the role of GLP-1 receptor agonists in weight loss and liver health, the evidence for Vitamin E and Pioglitazone in select patients, and the landmark approval of Resmetirom (Rezdiffra)—the first FDA-approved therapy for MASH with moderate to advanced fibrosis. Drawing from clinical trial data, including the MAESTRO-NASH trial, she explains mechanisms of action, efficacy outcomes, safety considerations, and practical prescribing guidance. This session underscores the importance of combining non-invasive testing, lifestyle interventions, and emerging pharmacologic therapies to improve patient outcomes and prevent progression to cirrhosis and liver-related complications.
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Common Questions From Primary Care Providers About MASH
August 2025
In this MASLD and MASH Community Network, Tessa Janovsky, PA-C at Arizona Liver Health, answers common questions from primary care providers about Metabolic Dysfunction–Associated Steatohepatitis (MASH) and its updated terminology. She explains why MASH has replaced the term NASH, highlighting the shift to reflect underlying metabolic drivers such as obesity and type 2 diabetes while removing stigmatizing language. Tessa discusses how normal or mildly elevated liver enzymes do not rule out MASH, the importance of screening high-risk groups—including patients with diabetes, obesity, metabolic syndrome, or incidental fatty liver on imaging—and why the FIB-4 score is the preferred first-line test for fibrosis risk assessment. She also reviews the first FDA-approved medication for MASH, resmetirom, as well as the role of GLP-1 therapies and upcoming treatment options. Whether you’re a clinician seeking updated screening guidelines or a patient wanting clarity on diagnosis and management, this session provides clear, evidence-based guidance on identifying and treating MASH.
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MASLD vs MetALD With Valerie Shin
September 2025
Valerie Shin, NP from UCLA Health’s Pfleger Liver Institute, hosts a clear, practical overview of MASLD, MASH, and mixed-etiology MET-ALD for the GHAPP MASLD Community Network (sponsored by Madrigal). Through a common patient case, she explains how to recognize steatotic liver disease, why getting an accurate alcohol history matters, and how non-invasive tools (like FibroScan and alcohol biomarkers) help confirm what’s driving liver injury. You’ll hear straightforward guidance on counseling patients: heart-healthy/Mediterranean-style eating, sustainable weight loss, regular aerobic and resistance exercise, and complete alcohol cessation—plus when to consider specialty referral and ongoing surveillance. Perfect for APPs and GI clinicians seeking a simple, patient-centered approach to preventing progression from fatty liver to advanced disease.
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MASLD vs MetALD With Janet Gripshover
September 2025
Janet Gripshover, NP, explains how to spot and manage metabolic dysfunction–associated steatotic liver disease (MASLD) and MASH—now the preferred terms replacing NAFLD. Through a real patient case, she shows how ultrasound findings, everyday risk factors (PCOS, high blood pressure, cholesterol, higher BMI), and an honest alcohol history point the way. Janet covers easy, non-invasive tests (FIB-4 blood test, FibroScan® stiffness and CAP scores) and when alcohol biomarkers (PEth, urine EtG) help confirm what’s really driving the liver damage. You’ll learn simple next steps: Mediterranean-style eating, resistance exercise, weight loss goals, and complete alcohol cessation to prevent progression to cirrhosis. She also notes when to start liver cancer (HCC) screening and what to document in the chart. Perfect for APPs and clinicians looking for a clear, practical MASLD/MASH workflow.
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MASLD Basics With Chantil Jeffreys
September 2025
In this MASLD/MASH Community Network “Basics” session, Chantil Jeffreys, NP clarifies the new MASLD/MASH nomenclature, how to recognize metabolic criteria (obesity, dyslipidemia, hypertension, impaired glucose/A1C, low HDL), and when to rule out other causes (alcohol overlap, DILI, cryptogenic disease). She walks through a practical primary-care workflow: start with FIB-4, then risk-stratify with FibroScan or ELF, identify patients who need hepatology referral, and decide when liver biopsy is appropriate (discordant/indeterminate NITs, suspected concomitant disease, select older patients). The talk covers global prevalence, natural history and progression (F0→F4/cirrhosis→HCC), and why aggressive cardiometabolic risk reduction and appropriate surveillance matter. You’ll leave with a clear algorithm to stage disease, monitor over time, and communicate the MASLD/MASH shift to colleagues and patients.
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MASLD vs MetALD With Tessa Janovsky
September 2025
Tessa Janovsky, PA-C, Arizona Liver Health, delivers a clear, case-based overview of metabolic dysfunction–associated steatotic liver disease (MASLD), MASH, and mixed-etiology MET-ALD. Using a common clinic scenario, she explains how to recognize fatty liver on imaging, why an accurate alcohol history matters, and how non-invasive tools (FibroScan stiffness/CAP and alcohol biomarkers like PEth) guide staging and care. You’ll learn practical, patient-friendly steps—Mediterranean-style nutrition, sustainable weight loss, regular aerobic and resistance exercise, and alcohol cessation—plus when to consider medications, specialist referral, and ongoing surveillance to prevent progression to advanced fibrosis and cirrhosis. Ideal for APPs and GI clinicians seeking straightforward strategies to manage MASLD/MASH in everyday practice.
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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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Common Questions From Primary Care Providers About MASH
August 2025
Join Sarah Dawkins, NP, for quick and practical insights in this edition of GHAPP MASLD Community Network’s APP Insights. Sarah answers common questions from primary care providers about managing patients with hepatic steatosis on imaging but normal liver tests. She explains when to calculate a FIB-4 score, how to interpret mild ALT/AST abnormalities, and when referral to hepatology is necessary. Learn how to assess risk in patients with diabetes, obesity, or metabolic syndrome, and how to rule out other causes like viral hepatitis, alcohol use, drug-induced liver injury, and iron overload. Sarah emphasizes the importance of lifestyle counseling for low-risk patients and provides a clear framework for primary care providers to confidently monitor and manage MASLD without unnecessary referrals. A must-watch for anyone navigating the "gray zone" of liver diagnostics in everyday practice.
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MASLD Pharmacotherapy With Jonathan Yeh
August 2025
In this GHAPP MASLD Community Network Education Series, Jonathan Yeh, PA from Columbia University Irving Medical Center, reviews the latest advances in pharmacotherapy for MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). This presentation explores the evolution from NAFLD to MASLD, highlighting why metabolic dysfunction is central to disease progression. Jonathan discusses the role of lifestyle modification, GLP-1 receptor agonists (such as semaglutide and tirzepatide), vitamin E, pioglitazone, and bariatric surgery, while focusing on resmetirom—the first FDA-approved therapy for adults with non-cirrhotic MASH and moderate to advanced fibrosis. The session explains how resmetirom works as a thyroid hormone receptor beta agonist, its clinical trial evidence from the MAESTRO-NASH study, patient eligibility, safety considerations, drug–drug interactions, and monitoring recommendations. With ongoing studies and expanding treatment options, this discussion provides clinicians with practical strategies for managing MASLD and MASH, improving liver outcomes, and addressing the challenges of insurance access and long-term therapy.
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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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