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MASLD AI 03:45 AM
August 2025
Join Brian Lam, PA-C, Associate Medical Director of Research at Inova’s Liver and Obesity Research Program and Chair of the Global NASH/MASH Council’s PA Committee, for a masterclass on non-invasive testing (NITs) in the evaluation of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH, presented through the GHAPP MASLD/MASH Community Network and sponsored by Madrigal Pharmaceuticals. In this dynamic and case-based session, Brian outlines a practical, step-by-step approach to identifying patients at risk for advanced fibrosis, using tools like FIB-4, ELF, FibroScan (VCTE), and MR Elastography. He walks through the critical cutoffs, diagnostic performance, limitations, and how to interpret imaging and lab-based scores in real-world hepatology and primary care settings. You'll learn how to apply AGA and AASLD clinical algorithms, the importance of staging patients with diabetes and metabolic syndrome, and how to distinguish low-risk MASLD from at-risk MASH. Brian also shares best practices for TE reliability, quality control, and using NIT combinations like FAST, MAST, and MEFIB for accurate diagnosis. With clear visuals, expert insights, and actionable takeaways, this session is an essential update for APPs, GI, hepatology, and primary care providers managing fatty liver disease in 2025 and beyond.
Related Podcast
Pharmacotherapy for MASH/MASLD: An Overview
September 2025
In this expert discussion, Anne Moore, NP with Arizona Liver Health in Phoenix, shares key insights into the evolving landscape of pharmacotherapy for MASH and MASLD. She explains the primary histological endpoints that matter most in clinical trials—MASH resolution and fibrosis improvement—and why these markers are critical for both regulatory approval and long-term patient outcomes. Anne highlights the approval of resmetirom, the first FDA-approved treatment for MASH with F2–F3 fibrosis, and reviews how it works as a selective THR-beta agonist to reduce liver fat and inflammation while improving fibrosis. Drawing on Phase 3 trial data, she outlines its efficacy, safety profile, and side effects, as well as strategies for monitoring patients through non-invasive testing, liver chemistries, and metabolic risk factors. This session also explores which patients are most appropriate candidates for MASH pharmacotherapy, with a focus on those at high risk of progression but still early enough in their disease to benefit. For advanced practice providers and hepatology specialists, this video provides a clear, practical roadmap to identifying, treating, and monitoring patients with MASH in everyday clinical practice.
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MASLD Basics With Suzanne Robertazzi
July 2025
Join Suzanne, a nurse practitioner from the Washington DC VA Medical Center, as she kicks off a comprehensive lecture series on steatotic liver disease, focusing on the evolving understanding of MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). In this foundational session, Suzanne walks through the new nomenclature replacing NAFLD and NASH, and outlines the clinical criteria used to identify and stratify patients along the MASLD–MASH spectrum. Learn how metabolic risk factors such as obesity, prediabetes, hypertension, and dyslipidemia contribute to disease progression, and explore the use of non-invasive diagnostic tools like Fib-4, FibroScan, and ELF scores to assess fibrosis. The session also discusses indications for liver biopsy, the implications of overlapping etiologies (like alcohol-associated liver disease), and strategies for identifying patients at high risk for cirrhosis, hepatocellular carcinoma (HCC), and liver-related mortality. This lecture equips clinicians, particularly those in primary care and hepatology, with a practical framework to evaluate steatosis, interpret metabolic profiles, and determine when to refer patients for specialty care. Whether you're new to liver disease or looking for updates on MASLD and MASH terminology, this session is an essential starting point.
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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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Beyond Basic NITs: When is Liver Biopsy or Advanced Imaging
July 2025
In this episode, Brian Lam, PA, Associate Director of Research at Inova’s Liver and Obesity Research Program in Northern Virginia, explores the nuanced decision-making involved in going beyond basic non-invasive tests (NITs) for diagnosing and managing MASH (metabolic dysfunction-associated steatohepatitis). While FIB-4 and transient elastography are useful initial tools, Brian breaks down when and why clinicians should consider more advanced diagnostics—such as MR elastography (MRE), proton density fat fraction (PDFF), and in certain cases, liver biopsy. Learn how to assess the reliability of a TE exam, interpret discordant NITs, and when to escalate to cross-sectional imaging or histologic confirmation. This podcast also highlights the evolving role of fat fraction in therapy response, limitations in current FDA indications for resmetirom, and how emerging data may shape future clinical pathways for patients with compensated cirrhosis. Whether you're in primary care, GI, or hepatology, this discussion offers critical insights to improve accuracy in staging liver disease and optimizing treatment strategies for patients with MASH.
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Podcast: Pharmacotherapy for MASH/MASLD: An Overview
June 2025
In this comprehensive episode, Christina Hanson, FNP-C at South Denver GI, provides an in-depth overview of pharmacotherapy for MASLD and MASH, with a focus on the FDA-approved therapy resmetirom (brand name Rezdiffra). Drawing on over 18 years of experience in hepatology and GI care, Christina explains the histologic endpoints used in clinical trials—MASH resolution and fibrosis improvement without worsening disease—and how they guided the approval of resmetirom. She breaks down the drug’s mechanism of action as a selective thyroid hormone receptor beta (THR-β) agonist, which promotes lipid metabolism and reduces liver inflammation without systemic toxicity. Christina reviews key Phase 3 data from the MAESTRO-NASH trial, showing resmetirom’s significant impact on both MASH resolution and fibrosis regression across diverse patient populations. She also outlines criteria for appropriate patient selection (those with stage F2-F3 fibrosis), clinical monitoring strategies, and management of side effects like transient GI discomfort. Christina emphasizes the importance of baseline screening for liver disease, autoimmune conditions, thyroid function, and lipid levels before initiating therapy. She highlights best practices from the 2024 AASLD guidelines for ongoing monitoring and treatment response assessment, including ALT and liver stiffness thresholds that help determine whether to continue or discontinue therapy. This episode is a must-watch for hepatology clinicians looking to implement evidence-based, patient-centered strategies in the management of MASH.
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Lifestyle Management With Whitney Steinmetz
July 2025
In this case-based clinical discussion, Whitney Steinmetz, FNP from Presbyterian Medical Group in Albuquerque, New Mexico, offers an in-depth review of lifestyle management strategies for patients with MASLD and MASH. Using the case of a 65-year-old male with persistently elevated ALT and metabolic syndrome, she highlights the importance of individualized, culturally competent counseling around nutrition, exercise, and behavioral change. Steinmetz outlines how tools like the FIB-4 score and FibroScan can help guide management and determine fibrosis risk, while emphasizing the critical role gastroenterology providers must play in addressing obesity, insulin resistance, and dietary habits. From the utility of motivational interviewing and realistic meal planning to the integration of caloric restriction and personalized exercise, this presentation equips clinicians with practical tools to support sustainable behavior change in patients with metabolic liver disease. Genetic factors, social determinants of health, and patient empowerment are all addressed, offering a holistic perspective on disease progression and prevention.
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MASLD vs MetALD With Christina Hanson
September 2025
Discover the latest insights on MASLD and MetALD in this educational session from the GHAPP MASLD Community Network. Christina Hanson, FNP-C, walks through a real-world case study to highlight how common metabolic conditions like hypertension, hyperlipidemia, obesity, and PCOS intersect with alcohol use to drive liver disease progression. The session explores updated nomenclature replacing NAFLD/NASH, the role of FibroScan and elastography in staging fibrosis, and the importance of screening patients with metabolic risk factors for fatty liver. Learn how alcohol consumption contributes to liver injury, triglyceride elevation, and blood pressure changes, and how objective biomarkers such as PEth testing are transforming diagnosis beyond self-reporting. Christina also reviews lifestyle interventions, dietary strategies like the Mediterranean diet, and current treatment considerations for patients with advanced fibrosis (stage 3), including when to initiate HCC screening. Whether you are a hepatologist, GI specialist, or advanced practice provider, this session provides practical tools for evaluating and managing patients with MASLD, MetALD, and related liver health challenges.
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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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Non-Invasive Testing With Maly Tiev
September 2025
Maly Tiev, NP, NYU Langone Health, shares a practical, case-based walkthrough of non-invasive testing (NITs) for MASLD/MASH—showing how to move from initial risk identification to confident staging and follow-up without a biopsy in most patients. Using Albert’s case, a 65-year-old with steatosis and mild ALT elevation, she explains how to apply FIB-4 first, then layer in FibroScan/VCTE with Liver Stiffness (kPa) and CAP for fat quantification, plus when to order ELF or MRI elastography. You’ll learn reliability checks for FibroScan, common confounders, insurance/operational tips for MRE, and an easy algorithm for primary care/endocrine clinics: start with FIB-4 → triage by cutoffs → use VCTE/ELF → refer when intermediate or high risk. She closes with clear next steps for low-risk patients—lifestyle modification, cardiometabolic optimization, and repeating NITs in 2–3 years—and when to escalate to hepatology for advanced disease.
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Common Questions From Primary Care Providers About MASH
August 2025
Join Maly Tiev, NP, NYU Langone Health, as she answers common questions from primary care providers about Metabolic Dysfunction-Associated Steatohepatitis (MASH). Learn who should be screened based on AASLD and American Diabetes Association guidelines, including patients with obesity, pre-diabetes or diabetes, metabolic syndrome, persistent ALT elevation, or steatosis on imaging. Molly explains when to refer MASH patients to gastroenterology or hepatology—such as those with FIB-4 scores over 1.3, suspected advanced fibrosis, or unexplained liver enzyme elevations—and addresses the safety of prescribing statins in MASH. Backed by multiple studies, she emphasizes that statins do not increase liver injury risk and can significantly reduce cardiovascular mortality, the leading cause of death in this population. This session provides practical, evidence-based guidance to help clinicians improve MASH detection, optimize referrals, and manage cardiovascular risk safely.
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