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MASLD AI 12:25 PM
September 2025
In this case-based session from the GHAPP MASLD Community Network, Patrick Horne, NP explains how to differentiate metabolic dysfunction–associated steatotic liver disease (MASLD) from metabolic dysfunction plus alcohol-associated liver disease (MetALD). Through the story of a 52-year-old patient with F3 fibrosis and severe steatosis, he reviews the modern SLD framework, metabolic risk factors (e.g., BMI, PCOS, hypertension, hyperlipidemia), and how alcohol intake interacts with insulin resistance, the gut microbiome, and hepatic lipid handling to accelerate inflammation and fibrosis. Patrick demonstrates practical tools—clear “standard drink” counseling, thorough history, AUDIT-C screening, and objective biomarkers like PEth—to uncover under-reported alcohol use and classify patients on the MASLD–MetALD–ALD spectrum. Management takeaways include Mediterranean-style nutrition, exercise and weight-loss targets, consideration of pharmacologic options in advanced fibrosis, firm guidance on alcohol cessation, and nuanced discussion of HCC surveillance in F3 disease. Ideal for APPs and hepatology clinicians, this talk delivers actionable algorithms, definitions, and trial-readiness considerations to standardize MetALD assessment and improve outcomes in steatotic liver disease.
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Common Questions from Primary Care Providers About MASH
July 2025
In this FAQ session, Brian Lam, PA-C, breaks down a common question he receives from primary care providers, endocrinologists, and even other GI specialists: Which patients with fatty liver should be referred to hepatology or GI for further evaluation? Using a clear and practical approach, Brian explains how to apply FIB-4, a simple lab-based non-invasive test, to guide referrals. He emphasizes that patients with metabolic syndrome—especially those with diabetes—are at significantly higher risk for MASH (Metabolic dysfunction-associated steatohepatitis), with roughly 1 in 3 diabetic patients affected. If the FIB-4 is greater than 1.3, or greater than 2.0 in adults over 65, it's time to refer. Brian also highlights the utility of FIB-4 with reflex to ELF, now available through major labs like LabCorp and Quest, as an efficient two-step method to detect advanced fibrosis and at-risk MASH. This video is perfect for busy clinicians looking for a referral-friendly workflow to catch MASH early and improve liver health outcomes in high-risk populations.
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MASLD Pharmacotherapy With Summer Collier
September 2025
Join Summer Collier, NP for a clear, clinic-ready overview of MASLD pharmacotherapy. This session explains why management starts with the metabolic syndrome—targeting obesity, type 2 diabetes, hypertension, and dyslipidemia—while reinforcing that lifestyle change (diet, physical activity, and 7–10% weight loss) remains the cornerstone. Summer reviews the role of GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) for weight reduction and glycemic control—including the anesthesia precaution to hold GLP-1 therapy 7 days before endoscopic procedures—and outlines liver-directed options: vitamin E (select non-diabetic patients, risks/limits), pioglitazone (cardiometabolic benefits vs. weight gain/edema considerations), and the first FDA-approved therapy for non-cirrhotic MASH with F2–F3 fibrosis, resmetirom (THR-β agonist targeting hepatic fat and inflammation). You’ll also hear practical tips on patient selection, staging and restaging with noninvasive tests (FIB-4, FibroScan®/elastography, MRI-PDFF, ELF), coordinating weight-management referrals, and planning follow-up. Ideal for GI/hepatology clinicians and APPs seeking an up-to-date, evidence-based roadmap to treat fatty liver disease and prevent progression to advanced fibrosis.
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Addressing Health Disparities: Equity Considerations in MASH/MASLD Care
July 2025
In this episode, Patrick Horne, NP at the University of Florida (UF Health), explores the impact of health disparities and socioeconomic inequality on the diagnosis and management of MASH (metabolic-associated steatohepatitis) and MASLD (metabolic dysfunction-associated steatotic liver disease). With a focus on rural and underserved populations, Patrick discusses how limited access to quality healthcare, healthy food, exercise options, and non-invasive testing (NITs) like FibroScan or MRI elastography can delay diagnosis and worsen outcomes. He shares practical, empathetic strategies for individualizing care, such as using accessible tools like FIB-4 or APRI, promoting low-cost physical activity like walking or swimming, and providing culturally sensitive nutrition advice tailored to financial and geographic realities. Patrick emphasizes the provider’s role as a patient advocate and coach, helping patients navigate barriers and create sustainable lifestyle modifications. This episode offers key insights for clinicians working to close gaps in care and promote equity in liver disease management.
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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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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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Non-Invasive Testing With Lindsay Pratt
July 2025
In this educational session from the GHAPP MASLD/MASH Community Network, Lindsay Pratt, PA-C from the University of Colorado, guides viewers through the practical application of non-invasive testing (NITs) for assessing fibrosis in patients with MASLD (Metabolic dysfunction-associated steatotic liver disease). Using a real-world case study, she highlights how to interpret FIB-4, ELF score, vibration-controlled transient elastography (VCTE/FibroScan®), and MR elastography (MRE) to stratify patients by risk and guide next steps in management. Lindsay explains the strengths and limitations of each NIT, how lifestyle modifications and cardiometabolic risk factors play a role in disease progression, and how tools like the AGA Clinical Care Pathway can be applied in day-to-day practice. This session is ideal for hepatologists, GI providers, APPs, and primary care professionals working to improve outcomes in patients with fatty liver disease—without relying on liver biopsy.
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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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Common Questions From Community GI About MASH
August 2025
In this MASLD Community Network episode, Valerie Shin, NP with UCLA Health Hepatology, addresses frequently asked questions from community GI providers about noninvasive tests (NITs) for assessing steatosis and fibrosis in MASLD and MASH. She reviews the benefits and key limitations of the FIB-4 score—highlighting the risk of false negatives in patients with normal AST/ALT levels, false positives in older patients, and inaccuracy when thrombocytopenia is unrelated to liver disease. Valerie explains when to consider second-line NITs, including transient elastography (FibroScan®), ELF score, and MR elastography, detailing their strengths, availability challenges, and technical limitations such as operator dependence, BMI restrictions, and insurance coverage issues. She also clarifies the rare but important role of liver biopsy when NITs produce conflicting or inconclusive results. Whether you’re a healthcare provider seeking practical diagnostic guidance or a patient wanting to understand your testing options, this video offers expert insights into selecting and interpreting noninvasive liver tests for MASLD and MASH.
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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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MASLD Pharmacotherapy With Whitney Steinmetz
August 2025
Join Whitney Steinmetz, NP, from Presbyterian Medical Group in Albuquerque, NM, for an in-depth review of pharmacotherapy in MASLD and MASH, presented as part of the GHAPP MASLD Community Network. In this comprehensive CME-eligible session, Whitney explores the multimodal treatment approach for patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH), focusing on three therapeutic pillars: obesity management, cardiometabolic risk reduction, and liver-directed therapies. The discussion covers mechanisms, clinical trial data, and practical considerations for key treatment options, including GLP-1 receptor agonists, vitamin E, pioglitazone, and resmetirom (Rezdiffra). Whitney highlights findings from landmark studies such as ESSENCE, PIVENS, and MAESTRO-NASH, and explains how thyroid hormone receptor beta activation through resmetirom reduces hepatic fat, inflammation, and fibrosis in F2-F3 patients. She also offers guidance on non-invasive monitoring (FibroScan, MRE, ALT), drug–drug interactions, and how evolving guidelines from AASLD and ESLD shape clinical decision-making. Whether you're treating early-stage fatty liver disease or managing moderate fibrosis in primary care or hepatology, this video provides evidence-based insights to optimize long-term outcomes through targeted pharmacologic strategies and patient-centered care.
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