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MASLD AI 08:47 AM
August 2025
Join April Morris, FNP, a hepatology and endocrinology nurse practitioner, for a comprehensive review of MASLD pharmacotherapy as part of the GHAPP MASLD Community Network. This expert-led session outlines a three-pronged strategy for managing Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH, focusing on obesity reduction, cardiometabolic risk control, and liver-directed treatment. April walks through first-line lifestyle approaches, highlights key pharmacologic agents like GLP-1 receptor agonists, and explains their mechanisms and clinical relevance—including the groundbreaking data from the semaglutide trials showing resolution of MASH and improvement in liver fibrosis. The session also reviews the role and limitations of vitamin E and pioglitazone, emphasizing their risks in patients with diabetes or cardiovascular disease. The spotlight then shifts to resmetirom (Rezdiffra), a thyroid hormone receptor beta agonist FDA-approved for adults with non-cirrhotic NASH and moderate-to-advanced fibrosis (F2–F3). April explains the MAESTRO-NASH trial endpoints, clinical efficacy, common side effects, and appropriate patient selection. Learn how resmetirom improves fatty acid oxidation, reduces hepatic fat and fibrosis, and the key drug–drug interactions and statin dose considerations to manage during treatment. The discussion concludes with practical tips for monitoring, non-invasive staging (FibroScan, ELF, MRI-PDFF), and the evolving guidance on treatment duration, safety labs, and insurance barriers. This session is essential for clinicians navigating the growing landscape of therapeutic options in MASLD/MASH care.
Related Podcast
PCP Screening for MASH/MASLD: Identifying At-Risk Patients
August 2025
Join Tessa Janovsky, PA-C from Arizona Liver Health, for a practical and guideline-based discussion on screening for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH) in primary care. This session outlines which patient populations Advanced Practice Providers (APPs) should routinely screen—such as individuals with type 2 diabetes, medically complicated obesity, metabolic risk factors with fatty liver on imaging, moderate alcohol use (MetALD), or a family history of MASH cirrhosis. Learn how to apply first-line non-invasive screening tools like FIB-4 and the NAFLD Fibrosis Score, understand their limitations, and incorporate them into busy clinic workflows. Tessa shares strategies for communicating positive results to patients, next steps for further evaluation (ELF test, FibroScan, MRI elastography), and criteria for timely referral to gastroenterology or hepatology. With practical tips for integrating MASLD/MASH screening into electronic medical records, building clinical pathways, and standardizing protocols, this episode equips PCPs and specialists to detect high-risk patients earlier, intervene effectively, and ultimately improve liver health outcomes.
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Lifestyle Management With Michelle Barnett
July 2025
Join Michelle Barnett, PA-C, for an in-depth clinical case presentation as part of the GHAPP MASLD Community Network. With over 25 years of experience in GI and hepatology, Michelle walks through the real-world management of Albert, a 65-year-old patient newly diagnosed with MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease). In this session, she outlines key diagnostic criteria, the role of non-invasive tests (NITs) like FIB-4 and FibroScan, and how to risk-stratify patients using updated care pathways. Learn how to differentiate low-, moderate-, and high-risk cases and when to refer for hepatology evaluation or consider biopsy. Michelle also explores the clinical role of Resmetirom—the first FDA-approved medication for patients with MASH and F2-F3 fibrosis—and emphasizes the importance of sustained lifestyle modification, dietary change, and exercise in liver disease management. This expert discussion includes cultural and socioeconomic considerations, adherence strategies, and patient tools like the Exercise and Diet Adherence Scale. Visit the GHAPP MASLD Community Network for more resources, disease-state education, and updates on the evolving care landscape. Educational content supported by Madrigal Pharmaceuticals.
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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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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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MASLD Basics With Melissa Franco
August 2025
Join Melissa Franco, PA-C, from the University of Miami for a comprehensive review of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and the 2023 nomenclature updates replacing NAFLD and NASH. Presented through the GHAPP MASLD Community Network and sponsored by Madrigal Pharmaceuticals, this session covers the spectrum of steatotic liver disease, including MASLD, MASH, MetALD, alcohol-related liver disease (ALD), and other causes of hepatic steatosis. Learn how to diagnose MASLD using imaging, cardiometabolic risk criteria, and how to exclude other causes like alcohol use, medications, and genetic disorders. Melissa explains how to risk stratify patients using FIB-4, FibroScan, and ELF testing, and when to consider referral to hepatology, especially for patients at intermediate or high risk for advanced fibrosis. The talk also explores global prevalence, natural history, disease progression to cirrhosis and HCC, and highlights the importance of identifying and managing patients with F2–F4 fibrosis, now classified as at-risk MASH. Through a real-world case study, viewers are guided on how to perform a thorough MASLD workup and assess patients for pharmacotherapy, lifestyle counseling, and surveillance protocols. Whether you are in primary care, GI, or endocrinology, this session is an essential resource for early diagnosis and comprehensive management of fatty liver disease in today’s clinical practice.
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MASLD Basics With Tessa Janovsky
August 2025
Join Tessa Janovsky, PA-C, from Arizona Liver Health, for this foundational session in the GHAPP MASLD Community Network, proudly sponsored by Madrigal Pharmaceuticals. This episode offers a comprehensive overview of the updated nomenclature and clinical approach to steatotic liver disease, covering the transition from NAFLD/NASH to MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction-Associated Steatohepatitis). Tessa breaks down the rationale behind this global reclassification and explains how it improves diagnostic clarity while reducing stigma. You’ll learn how to identify MASLD using cardiometabolic risk factors, apply non-invasive risk stratification tools like FIB-4, FibroScan, and ELF, and determine when to refer patients for hepatology care. She also discusses the natural history of MASLD progression, the risk of cirrhosis and HCC, and the clinical importance of early detection and treatment. Real-world case studies guide providers through assessing common patient presentations, ruling out alternative etiologies, and considering pharmacologic therapy like resmetirom when appropriate. This is an essential watch for APPs, PCPs, and GI providers working to better understand and manage MASLD and MASH in clinical practice.
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Podcast: LFTs Demystified: A Practical Guide for APPs
June 2025
In this podcast episode, Michelle Barnett, PA-C, a liver disease specialist based in Colorado Springs, provides a clear and practical overview on demystifying liver enzyme abnormalities—particularly in the context of MASH (Metabolic Dysfunction–Associated Steatohepatitis) and MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease). With MASLD affecting nearly 1 in 4 American adults, understanding liver enzyme patterns is critical for early detection and effective management. Michelle breaks down commonly reported values from hepatic function panels—ALT, ALP (alkaline phosphatase), and total bilirubin—explaining what constitutes normal, acute, subacute, and chronic elevations. She walks through hepatocellular, cholestatic, mixed, and isolated hyperbilirubinemia patterns and what they reveal about underlying liver conditions such as MASH, alcohol-associated liver disease, viral hepatitis, biliary obstruction, and drug-induced liver injury. Whether you're a provider or a patient looking to better understand lab results, this episode delivers expert guidance on interpreting liver enzyme elevations to support more informed clinical decisions.
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Alcohol and MASLD/MASH: Navigating the Complex Relationship
August 2025
Join Edith Johannes, NP, UCLA Health, for an in-depth discussion on alcohol consumption in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Alcohol-Related Liver Disease (MetALD). Drawing on over 17 years of experience in liver disease and transplant care, Edith explains the clinical importance of accurately screening and quantifying alcohol use to differentiate between MASLD, MetALD, and Alcohol-Related Liver Disease (ALD). Learn the acceptable alcohol thresholds, how alcohol impacts diagnostic accuracy for fibrosis, and why precise history-taking—down to grams per day—is essential for guiding treatment. This session covers practical strategies for effective patient conversations, cultural sensitivity, use of validated screening tools (CAGE, AUDIT, AUDIT-C), and tips for uncovering underreported intake. Discover how alcohol use can confound non-invasive testing like FIB-4 and elastography, influence eligibility for pharmacotherapy, and accelerate disease progression, cardiovascular risk, and mortality. With a focus on early intervention, lifestyle modification, and multidisciplinary support for alcohol cessation, this talk provides actionable insights for improving liver health outcomes in MASLD and MetALD patients.
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Podcast: Alcohol and MASLD/MASH: Navigating the Complex Relationship
June 2025
In this powerful and highly educational episode, Scott Springer, PA-C at Erie County Medical Center in Buffalo, NY, explores the complex and often overlooked relationship between alcohol use and metabolic dysfunction–associated steatotic liver disease (MASLD/MASH). Drawing from his dual expertise in hepatology and addiction medicine, Scott outlines the importance of accurately assessing alcohol use when diagnosing MASLD, MASH, MetALD, or ALD—emphasizing that MASLD and MASH are diagnoses of exclusion and heavily influenced by alcohol consumption thresholds. He discusses best practices for screening, including patient-centered, nonjudgmental interviewing, the use of biomarkers like PEth and urine ethyl glucuronide, and how these tools enhance accuracy and accountability in care. Scott reviews national guidelines that recommend alcohol abstinence for patients with chronic liver disease and presents data showing how even small reductions in alcohol use can significantly lower the risk of cirrhosis. He also unpacks the challenges of interpreting liver tests in patients with ongoing alcohol use, the limitations of non-invasive testing like FibroScan and FIB-4, and how alcohol may disqualify patients from emerging pharmacotherapy such as resmetirom. Finally, he highlights the promising potential of GLP-1 medications in managing both liver fibrosis and alcohol use. This episode is essential listening for hepatology providers, addiction specialists, and any clinician involved in the care of patients with coexisting liver disease and substance use disorders.
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Non-Invasive Testing With Elizabeth Alqueza
August 2025
In this session, Elizabeth Alqueza, PA-C at Beth Israel Deaconess Medical Center, provides a comprehensive overview of non-invasive testing in patients with Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and MASH. Using a real clinical case, she explains how to evaluate patients with abnormal liver enzymes and steatosis on imaging, and how to apply widely used tools such as the FIB-4 score, ELF test, FibroScan (VCTE), CAP score, shear wave elastography, and MR elastography. Elizabeth highlights the strengths, limitations, and interpretation of each test, along with practical considerations like cost, accessibility, patient factors, and operator experience. She also reviews the MASLD care pathway, emphasizing how accurate staging with non-invasive tests helps identify at-risk patients with advanced fibrosis who need closer monitoring, lifestyle interventions, and specialty referral. This talk underscores the critical role of non-invasive assessment in preventing progression to cirrhosis, liver failure, and hepatocellular carcinoma.
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