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MASLD AI 02:56 AM
July 2025
In this dynamic and highly informative session, Sherona Bau, NP, presents a comprehensive overview of pharmacotherapy in MASLD and MASH, breaking down current treatment strategies and emerging therapies for patients with metabolic dysfunction-associated steatotic liver disease. This presentation, part of the MASLD/MASH Community Network, begins by contextualizing the recent nomenclature shift from NAFLD/NASH to MASLD/MASH and its clinical implications. Sherona explores lifestyle intervention targets, including Mediterranean diet, weight loss goals based on fibrosis stage, and the role of GLP-1 and GIP receptor agonists in improving liver health. She highlights the ESSENCE trial results for semaglutide, discusses the only FDA-approved therapy to date—resmetirom (Rezdiffra)—and explains its mechanism of action via thyroid hormone receptor beta activation. The session dives deep into efficacy data from the MAESTRO-NASH trial, side effect profiles, drug–drug interactions, and monitoring recommendations. She also previews a pipeline of promising agents in phase 2 and 3 trials—including tirzepatide (GLP-1/GIP), cotadutide (GLP-1/GR), pemvidutide (GLP-1/GIP), and retatrutide (GLP-1/GIP/GR)—offering insight into what’s next in the evolving treatment landscape. This is a must-watch for hepatology and endocrinology clinicians focused on the future of fatty liver management.
Related Podcast
Podcast: Role of Exercise in Liver Health
June 2025
In this engaging episode of the GHAPP MASLD/MASH Community Network podcast, Jonathan Yeh, PA at Columbia University Medical Center, discusses the essential role of exercise in liver health—especially in managing MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). With over 14 years of hepatology experience, Jonathan breaks down the most effective types of physical activity, highlighting the benefits of combining aerobic and resistance training over high-intensity interval training (HIIT) alone. He provides practical, personalized exercise recommendations tailored to patients’ physical abilities, access to resources, and comorbidities—including suggestions for those with mobility limitations or time constraints. Jonathan also offers motivational strategies to help patients overcome common barriers such as lack of time, motivation, or access to fitness facilities. From parking farther from a destination to lunchtime walks and home-based workouts using resistance bands, he emphasizes creative and realistic ways to build physical activity into daily routines. Beyond weight loss, he explains how exercise directly improves liver function by reducing liver fat, enhancing insulin sensitivity, and preventing fat and sugar buildup in the liver. This episode is a must-watch for clinicians and patients alike seeking to understand and implement exercise as a cornerstone in the management of fatty liver disease.
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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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GHAPPcast: Recognizing the Severity of MASH
January 2025
Thank you to Madrigal for sponsoring this episode of GHAPPcast. In this episode of GHAPPcast, nurse practitioners Patrick Horne and April Morris from discuss the complexities of identifying and managing patients with metabolic-associated steatohepatitis (MASH). They explore clinical approaches, including the use of bloodwork, family history, and advanced diagnostic tools such as FibroScan, to recognize patients at risk. Patrick and April emphasize the importance of lifestyle interventions like diet and exercise alongside new medical therapies, while also offering practical tips for clinicians on patient monitoring and treatment management. Tune in for valuable insights into managing MASH in clinical practice.
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Monitoring for MASLD in Type 2 Diabetes
July 2025
In this episode, Kelly Smeester, PA-C from South Denver Gastroenterology, explores the critical intersection of type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD). Drawing from her background in both hepatology and endocrinology, Kelly offers practical, evidence-based strategies for non-invasive monitoring of liver fibrosis in patients with diabetes who may initially appear low risk. She highlights the utility of tools like FIB-4, ELF score, FibroScan, and MR elastography, while emphasizing the limitations of relying solely on liver function tests (LFTs). Kelly recommends annual FIB-4 screening—easily calculated with existing lab values—and discusses when to escalate to more advanced diagnostics. She also shares how advanced practice providers (APPs) can seamlessly integrate MASH education, lifestyle counseling, and routine screening into the diabetes care workflow, supporting early intervention and long-term liver health. This episode is a must-listen for clinicians looking to optimize care for patients at risk of silent liver disease progression in the setting of metabolic co-morbidities.
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MASLD Basics With Ellie Gonyeau
August 2025
Join Ellie Gonyeau, NP, a GI and hepatology nurse practitioner at Beth Israel Deaconess Medical Center in Boston, for a foundational overview of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), formerly known as NAFLD. Presented through the GHAPP MASLD Community Network and sponsored by Madrigal Pharmaceuticals, this session covers the latest updates in MASLD nomenclature, diagnostic criteria, and non-invasive evaluation strategies. Ellie walks through the 2023 guidelines, emphasizing how MASLD is defined by hepatic steatosis in the presence of at least one metabolic risk factor—such as obesity, type 2 diabetes, hypertension, or dyslipidemia—and the importance of ruling out excessive alcohol use and other causes of chronic liver disease. Using real-world case examples like "JP", Ellie illustrates how to assess disease severity using tools such as FIB-4, FibroScan, and lab workups, while explaining when to consider specialty referral, further imaging, or liver biopsy. The talk also highlights the alarming rates of MASLD in high-risk populations, such as the Latin American community, and explores the disease's potential to silently progress to MASH, fibrosis, or cirrhosis. Whether you're in primary care, GI, or hepatology, this session provides critical insights on early detection, risk stratification, and guideline-based management of this increasingly prevalent condition.
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Comparing F3 and F4 Fibrosis With Michelle Barnett
July 2025
In this installment of the GHAPP MASLD Community Network, Michelle Barnett, PA-C from Peak Gastroenterology in Colorado Springs, presents a deep dive into the clinical management of MASH—formerly known as NASH or non-alcoholic steatohepatitis. Through two comparative case studies, Michelle explores the nuances of diagnosing and managing patients with F3 and F4 fibrosis. Learn how to effectively use non-invasive diagnostic tools like FIB-4, FibroScan, and ELF testing, and gain valuable insights into stratifying fibrosis risk, monitoring hepatocellular carcinoma (HCC), and determining when resmetirom is appropriate. This session also covers practical guidance on nutrition, exercise, medication safety, and multidisciplinary care for patients with advanced liver disease. Whether you're a hepatology specialist or a primary care provider navigating the MASLD/MASH landscape, this video offers actionable strategies to improve long-term patient outcomes and reinforces the critical role of lifestyle intervention and liver disease surveillance.
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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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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 Lindsay Pratt
July 2025
Join Lindsey Pratt, PA-C from the University of Colorado Liver Transplant Program, for an in-depth clinical comparison of F3 and F4 fibrosis in patients with MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). Using an identical patient profile with differing non-invasive testing results, Lindsey demonstrates how to accurately stage fibrosis using tools like FIB-4, FibroScan, CAP score, and ELF test—emphasizing when pharmacologic intervention is appropriate and when advanced monitoring becomes critical. This session explores the clinical implications of fibrosis staging, treatment pathways including resmetirom (Rezdiffra), the role of GLP-1 receptor agonists, and practical nutrition and lifestyle strategies. For F4 patients, Lindsey outlines key elements of surveillance for hepatocellular carcinoma (HCC), portal hypertension management, and transplant evaluation. Whether you're in hepatology or primary care, this case-based discussion offers evidence-backed guidance for managing patients across the MASLD/MASH spectrum and preventing liver disease progression.
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Comparing F3 and F4 Fibrosis With Scott Springer
August 2025
Join Scott Springer, PA-C, from Erie County Medical Center in Buffalo, NY, for a case-based clinical discussion on how to evaluate and manage F3 vs. F4 fibrosis 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 a detailed side-by-side comparison of a fictional patient "Sam," Scott demonstrates how to interpret key non-invasive testing modalities—including FIB-4, ELF, and FibroScan—to stage liver fibrosis, determine candidacy for emerging therapies like resmetirom (Rezdiffra), and identify when liver biopsy may still be necessary. Learn how changes in platelet count, ELF score, and liver stiffness (kPa) help distinguish advanced fibrosis (F3) from cirrhosis (F4) and how this affects treatment decisions, HCC surveillance, and portal hypertension management. Scott also emphasizes the role of GLP-1 therapy, aggressive cardiometabolic risk reduction, and lifestyle counseling as core strategies in MASLD care. This session is a practical guide for GI and hepatology providers navigating MASLD staging, treatment eligibility, and long-term monitoring in 2025 and beyond.
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