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MASLD AI 03:45 AM
September 2025
In this session from the MASLD Community Network, Melissa Franco, PA from the University of Miami, provides a comprehensive overview of pharmacotherapy for MASLD and MASH. She reviews the role of lifestyle interventions such as the Mediterranean diet, weight loss, and exercise while highlighting the importance of controlling metabolic and cardiovascular risk factors including diabetes, hypertension, and dyslipidemia. Melissa discusses pharmacologic options including GLP-1 receptor agonists like semaglutide, which have shown promise in improving both weight loss and liver histology, as well as the evolving roles of vitamin E, pioglitazone, and resmetirom (Rezdiffra)—the first FDA-approved therapy for non-cirrhotic MASH with stage 2–3 fibrosis. Practical considerations, safety profiles, drug-drug interactions, and monitoring strategies are explained, giving clinicians a clear framework for managing patients with fatty liver disease. This session emphasizes why a combination of lifestyle changes, risk factor control, and emerging pharmacologic therapies are critical for improving outcomes in MASLD and MASH.
Related Podcast
MASLD Pharmacotherapy With Chantil Jeffreys
September 2025
In this MASLD Community Network webcast, Chantil Jeffreys, NP, walks through a practical framework for pharmacotherapy in MASLD/MASH—from lifestyle-first approaches to the evolving role of GLP-1 receptor agonists and bariatric/endoscopic options. She clarifies common misconceptions (e.g., statins are safe—and beneficial—for patients with fatty liver), reviews evidence and real-world considerations for vitamin E and pioglitazone, and explains where resmetirom (Rezdiffra) fits today for non-cirrhotic MASH with F2–F3 fibrosis—including monitoring, drug–drug interactions, and documentation tips that support payer approval. The session also covers cardiovascular risk reduction, peri-procedure guidance for GLP-1s, and practical strategies for staging and follow-up so clinicians can confidently personalize therapy and improve outcomes.
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HCC Surveillance: Implementation in Patients with Advanced Fibrosis/Cirrhosis from MASH
July 2025
In this episode of the GHAPP MASLD Community Network podcast, Lisa Richards, a hepatology-focused nurse practitioner in San Diego, shares expert insights on hepatocellular carcinoma (HCC) surveillance for patients with advanced fibrosis and cirrhosis due to MASH (metabolic dysfunction-associated steatohepatitis). Lisa outlines which patients require routine HCC surveillance, emphasizing the importance of staging—particularly stages F3 and F4—and how AASLD guidelines guide surveillance strategies. She discusses recommended surveillance modalities, including ultrasound with AFP every six months, and introduces the LIRADS visualization score to help interpret imaging quality and follow-up needs. Lisa also addresses practical challenges in implementation, from patient education and engagement to overcoming barriers like cost, transportation, and care coordination. For advanced practice providers (APPs), this podcast delivers clear guidance on what to do when new liver lesions are detected and how to proceed with diagnostic imaging and referrals for multidisciplinary review or intervention. Empower your clinical practice with strategies that promote early detection and improve outcomes in patients at risk of HCC.
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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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MASLD vs MetALD With Christie Morrison
September 2025
In this MASLD Community Network session, Christie Morrison, NP, shares a practical case study to explain how to recognize and manage metabolic dysfunction–associated steatotic liver disease (MASLD), MASH, and mixed-etiology MET-ALD. She highlights how common risk factors like obesity, diabetes, high blood pressure, and regular alcohol use can overlap and accelerate liver damage. Christy also discusses how non-invasive testing helps stage disease, why accurate alcohol history is important, and what steps providers can take to support patients. Lifestyle changes such as adopting a healthier diet, increasing physical activity, losing weight, and reducing alcohol intake remain the foundation of care. This overview is designed for APPs and GI clinicians looking for clear, practical strategies to help patients prevent progression to advanced liver disease.
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Common Questions From Patients About MASH
July 2025
In this practical and patient-focused discussion from the GHAPP MASLD/MASH Community Network, we address some of the most frequently asked questions by patients newly diagnosed with MASLD (Metabolic dysfunction-associated steatotic liver disease). Many patients wonder how they can have liver disease if they don’t drink alcohol. This video explains the evolution from NAFLD to MASLD, emphasizing that MASLD is rooted in metabolic risk factors—not alcohol use—and commonly affects individuals with diabetes, obesity, and hypertension. Viewers will also learn about evidence-based lifestyle interventions, including the benefits of a hypocaloric diet, the recommended Mediterranean-style eating pattern, and 150 minutes of weekly physical activity. Finally, we tackle the question “Is MASLD curable?” with empowering guidance on how weight loss and exercise can help reverse liver damage and reduce liver fat. This is a must-watch for clinicians, care teams, and patients seeking clarity and confidence in managing this increasingly common liver disease.
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Common Questions from Community GI About MASH
July 2025
In this insightful video, Christie Morrison, a local advanced practice provider with the GHAPP MASLD/MASH Community Network, answers two of the most frequently asked questions from community GI providers: when to refer patients with MASH to a transplant center and how to evaluate liver fibrosis when FibroScan® isn’t accessible. Christy emphasizes the importance of using non-invasive testing (NITs)—including FIB-4 and ELF (Enhanced Liver Fibrosis) scores—to help identify patients with F3 fibrosis, who are at higher risk for rapid progression to cirrhosis and hepatocellular carcinoma (HCC). She encourages early referral to transplant hepatology to avoid delays in care, especially given long wait times and the value of multidisciplinary support teams at transplant centers. For clinicians without access to FibroScan, Christy shares practical alternatives such as ordering reflex testing to ELF via major labs and leveraging easy-to-use digital tools like MDCalc for FIB-4 calculation. This episode is a valuable resource for GI providers looking to optimize liver care pathways and prevent late-stage complications in MASLD and MASH patients.
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MASLD vs MetALD With Maribeth Capuno
September 2025
In this case-based talk from the GHAPP MASLD Community Network, Maribeth Capuno, DNP reviews how to differentiate metabolic dysfunction–associated steatotic liver disease (MASLD) from metabolic dysfunction plus alcohol-associated liver disease (MetALD). Using a 52-year-old patient with ultrasound-confirmed steatosis, metabolic risks (PCOS, hypertension, hyperlipidemia, prediabetes), and daily wine intake, she walks through labs and noninvasive testing—FibroScan 11.4 kPa (F3 fibrosis) and CAP 310 (severe steatosis)—plus an objective PEth biomarker of 120 indicating moderate–heavy alcohol use. The session covers the SLD spectrum, “standard drink” counseling, why questionnaires (AUDIT) and biomarkers (PEth) uncover under-reported alcohol use, and how alcohol synergizes with insulin resistance and dyslipidemia to accelerate fibrosis and decompensation risk. Practical management includes Mediterranean-style nutrition, exercise with 5–10% weight-loss goals, strict alcohol cessation, medication considerations for advanced fibrosis, and HCC surveillance in F3 disease. Ideal for APPs and hepatology clinicians, this video delivers step-by-step evaluation, diagnostic criteria, and clear, patient-education talking points to improve MASLD/MetALD assessment and outcomes.
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Discordant NITs: The Gray Zone
August 2025
Join Melissa Franco, PA at the University of Miami, for an in-depth episode of the GHAPP MASLD Community Network podcast focused on discordant non-invasive tests (NITs) and navigating the "gray zone" of liver fibrosis staging. Melissa walks through common real-world scenarios where FIB-4, FibroScan, ultrasound, ELF score, and MR elastography deliver conflicting results—exploring why this happens and how to approach it clinically. Learn how patient factors such as obesity, alcohol use, co-morbidities, medications, and test limitations can impact NIT interpretation. Discover Melissa’s expert strategies for re-evaluating results, when to consider liver biopsy, and how to communicate these complexities with patients. From understanding how false elevations occur to using imaging and labs to confirm or exclude advanced fibrosis, this episode provides a practical and evidence-based approach to staging MASLD and MASH when results don’t align. Whether you're managing metabolic liver disease in hepatology or primary care, this is essential listening for interpreting liver diagnostics in nuanced clinical settings.
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Common Questions from Patients About MASH
July 2025
In this focused episode, Suzanne Robertazzi, NP at the Washington DC VA, shares expert insights on how to prevent recurrence of MASH (Metabolic-associated steatohepatitis) and MASLD (Metabolic dysfunction-associated steatotic liver disease) in liver transplant recipients. Drawing on her experience caring for post-transplant veterans, Suzanne explains that MASH can return even after liver transplantation, making ongoing metabolic management essential. She outlines key strategies including tight blood sugar and blood pressure control, especially since transplant medications can contribute to hypertension. Suzanne also emphasizes the importance of introducing regular physical activity post-recovery and adopting a Mediterranean-style diet—while tailoring nutrition guidance to meet the needs of patients in urban settings with limited access to fresh foods. This video is a must-watch for transplant teams, hepatology providers, and patients seeking to extend the life and health of their new liver through evidence-based lifestyle and clinical interventions.
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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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