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MASLD AI 02:26 AM
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.
Related Podcast
Comparing F3 and F4 Fibrosis With Erin Tanner
July 2025
Join Erin Tanner, NP from Gastro Health in Birmingham, Alabama, for a practical and in-depth exploration of how to differentiate and manage patients with F3 versus F4 fibrosis in the setting of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH. This session, part of the MASLD & MASH Community Network, features two detailed case studies—Sam A and Sam B—who share identical comorbidities but diverge in fibrosis stage, illustrating how non-invasive testing (NITs) can guide diagnosis and treatment. Erin walks through the clinical application of tools like FIB-4, FibroScan (VCTE), ELF test, and CAP score, emphasizing the importance of interpreting lab and imaging results in context. The discussion covers key decision points, including when to initiate pharmacologic therapy like resmetirom (Rezdiffra), how to determine eligibility for HCC surveillance, and when to consider liver biopsy. She also addresses common challenges in community GI settings, such as incidental fatty liver findings, elevated ferritin levels, and the limitations of FIB-4 in older or diabetic patients. Whether you're in hepatology, gastroenterology, or primary care, this talk offers actionable insights on fibrosis staging, lifestyle counseling, and long-term monitoring in patients with MASLD and MASH.
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MASLD Basics With Summer Collier
July 2025
Join Summer Collier, NP from UC San Diego Health, for an essential overview of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) in this GHAPP MASLD Community Network session. Designed for clinicians and healthcare professionals, this case-based talk covers the evolving nomenclature shift from NAFLD/NASH to MASLD/MASH, including key definitions, diagnostic criteria, and practical tools for identifying and managing patients with steatotic liver disease. Summer walks through foundational concepts like the role of hepatic steatosis, cardio-metabolic risk factors, and the importance of excluding significant alcohol use to establish a MASLD diagnosis. She also provides clinical insights into non-invasive fibrosis staging using FIB-4, FibroScan, elastography, and blood-based tests, as well as how to differentiate patients who may require hepatology referral or biopsy. Emphasizing the importance of early detection and risk stratification in primary care, this session highlights how fibrosis stage impacts prognosis, treatment planning, and long-term liver-related outcomes. For more educational sessions and MASLD tools — visit the GHAPP MASLD Community Network.
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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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Serological Workup: A Step-by-Step Guide
July 2025
In this comprehensive video, Sherona Bau, NP from UCLA, breaks down the essential hepatology workup for patients with MASLD (formerly NAFLD) and MASH, offering guidance for both primary care providers and GI/hepatology specialists. Drawing from her extensive clinical experience, she outlines a systematic approach to evaluating abnormal liver ultrasound findings—starting with critical labs to rule out chronic liver conditions like hepatitis B, hepatitis C, autoimmune hepatitis, PBC, and hereditary hemochromatosis. Sherona discusses the importance of ordering ANA, AMA, ferritin, serologies, and even specialized labs like the phosphatidylethanol (PEth) test to uncover alcohol-related liver disease that may be overlooked. She emphasizes the need to screen for cardiometabolic risk factors including type 2 diabetes and dyslipidemia and highlights non-invasive tests such as FibroScan and FIB-4 to help identify patients at risk of advanced fibrosis who may benefit from specialist referral. Most importantly, Sherona addresses the fears many patients face around liver disease progression and life expectancy, encouraging early intervention and coordinated care to improve long-term outcomes. This video is a must-watch for any clinician managing steatotic liver disease.
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MASLD Pharmacotherapy With Kelly Smeester
August 2025
Join Kelly Smeester, MMS, RD, PA-C, from South Denver Gastroenterology for an in-depth pharmacologic review of current and emerging treatment options for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH (Metabolic Dysfunction-Associated Steatohepatitis), as part of the GHAPP MASLD Community Network. This session outlines a comprehensive treatment strategy focused on three key goals: promoting weight loss, reducing cardiovascular risk, and targeting liver-specific interventions. Kelly highlights lifestyle and pharmacologic interventions including GLP-1 receptor agonists, GIP/GLP-1 dual agonists, and bariatric surgery, while exploring evidence-based guidance for treating comorbidities like type 2 diabetes, hypertension, and dyslipidemia. She dives into the latest data on vitamin E, pioglitazone, and the newly FDA-approved Resmetirom (Rezdiffra)—a thyroid hormone receptor beta agonist indicated for adults with non-cirrhotic NASH and F2–F3 fibrosis. Learn about the results from pivotal clinical trials like ESSENCE, PIVENS, and MAESTRO-NASH, the importance of NAFLD activity scoring, as well as dosing strategies, adverse effects, and drug interactions to consider when using Resmetirom. The session also explores practical monitoring approaches including FibroScan, MRI-PDFF, and ELF scores, with an outlook on evolving treatment duration and insurance coverage considerations. Whether you're a hepatology provider or part of a multidisciplinary care team, this presentation offers critical insights to optimize MASH treatment pathways today and in the future.
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Monitoring for MASLD in Type 2 Diabetes
July 2025
In this episode of the GHAPP MASLD podcast series, Lavinia Iordache, PA-C from the University of Miami, shares expert guidance on monitoring metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes—a group at particularly high risk for disease progression. Lavinia explains the bidirectional relationship between MASLD and diabetes, highlighting the importance of early screening, timely non-invasive testing (NITs), and proactive management strategies to prevent advanced fibrosis and cirrhosis. She reviews essential tools such as FIB-4, ELF score, FibroScan, and MRI-PDFF, and offers clear recommendations on when to escalate care, refer to specialty clinics, or intensify follow-up. The discussion also covers the role of lifestyle interventions including the Mediterranean diet, intermittent fasting, exercise, and coffee consumption, as well as strategies to improve adherence despite psychosocial, cultural, or financial barriers. Lavinia emphasizes a multidisciplinary approach to managing MASLD and provides practical tips for tracking lifestyle changes, such as journaling and the use of the EDAS questionnaire. Whether you’re a GI, endocrinology, or primary care provider, this episode offers an actionable roadmap for reducing liver-related complications in patients with diabetes.
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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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Non-Invasive Testing With Oyin Penny
August 2025
In this GHAPP MASLD Community Network presentation, Oyin Penny, FNP, from Premier Gastroenterology of Kansas City, explores the evolving role of non-invasive testing (NITs) in assessing MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). Through a detailed case study of a 65-year-old male with obesity, diabetes, hypertension, and hyperlipidemia, we review how imaging biomarkers such as FibroScan, MR Elastography, CAP score, and MRI-PDFF, as well as clinical prediction tools like FIB-4 and ELF score, are applied to evaluate fibrosis risk and guide management decisions. This session highlights the strengths and limitations of various NITs, emphasizes the importance of accurate fibrosis staging, and outlines when to repeat testing, escalate to hepatology referral, or initiate therapy. The discussion underscores the critical need for early detection, risk stratification, and proactive management of liver disease in patients with metabolic risk factors to prevent progression to cirrhosis and improve long-term 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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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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