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MASLD AI 06:15 AM
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.
Related Podcast
Lifestyle Management With Jennifer Geremia
August 2025
In this GHAPP MASLD Community Network presentation, Jennifer Geremia, PA-C, from Brigham and Women’s Hospital in Boston, discusses the critical role of lifestyle modifications in managing MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). Using a case-based approach, she highlights how patients with obesity, type 2 diabetes, hypertension, and hyperlipidemia can benefit from evidence-based interventions including dietary changes, weight reduction, and physical activity. The session emphasizes the importance of achieving and maintaining 7–10% weight loss, the benefits of a Mediterranean diet, and combining aerobic and resistance exercise to improve liver health and reduce progression to advanced fibrosis or cirrhosis. Jennifer also explores the challenges of long-term adherence, the impact of genetic and metabolic risk factors, and strategies for engaging patients in realistic and sustainable lifestyle changes. This program underscores how early intervention and multidisciplinary care can prevent liver disease progression and improve outcomes for at-risk patients.
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Addressing Health Disparities: Equity Considerations in MASH/MASLD Care
July 2025
In this powerful and timely episode, Robin Soto, FNP at UC San Diego Health, explores the deep-rooted health disparities impacting patients with MASH (metabolic dysfunction-associated steatohepatitis) and MASLD (metabolic dysfunction-associated steatotic liver disease). With a focus on equity in liver care, Robin highlights the disproportionate burden of disease in Hispanic and underserved populations and the complex interplay of genetics, socioeconomic status, healthcare access, and systemic bias that drives these outcomes. She shares actionable strategies for advanced practice providers (APPs) to implement culturally sensitive communication, bias-conscious screening protocols using tools like FIB-4, NAFLD fibrosis score, and transient elastography, and how to leverage telehealth and community partnerships to bridge gaps in care. Robin also addresses the importance of culturally relevant dietary counseling, inclusive family engagement, and motivational interviewing to enhance adherence and improve long-term outcomes. Whether you're in primary care, hepatology, or community health, this episode offers a roadmap to advance health equity in the management of fatty liver disease.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Scott Springer, PA-C, from Erie County Medical Center in Buffalo, NY, addresses one of the most common misconceptions in liver health—trusting over-the-counter supplements and detox products to improve liver function. Drawing from his experience in both hepatology and addiction medicine, Scott emphasizes that many non-prescribed products marketed for liver support are not only ineffective but can actually cause liver harm. He cautions against relying on unregulated supplements and urges patients to consult medical professionals before taking anything for liver health. One surprising and evidence-based recommendation he makes: drink coffee. Filtered coffee, in particular, has been shown to support liver health and may reduce the risk of liver disease progression. Scott recommends two to three cups per day, without added sugar or excess dairy—especially for patients with MASLD or MASH. This video offers practical, research-backed advice for patients and providers alike, highlighting what truly helps (and what may harm) the liver.
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LFTs Demystified: A practical guide for APPs
July 2025
In this GHAPP MASLD Community Network podcast, Jessica Crimaldi, NP, from the Cleveland Clinic, provides practical, real-world insights into interpreting liver function tests (LFTs) in the context of MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH (steatohepatitis). Drawing on over a decade of experience in GI and hepatology, Jessica explains common ALT and AST elevation patterns that should prompt a diagnostic workup, even in asymptomatic patients. She reviews the hepatocellular vs. cholestatic patterns of injury, the value of the R-factor calculator in identifying the likely etiology of liver enzyme abnormalities, and how to differentiate MASH from other liver diseases such as PBC, viral hepatitis, or bile duct obstruction. The episode also addresses key non-liver labs like triglycerides, A1C, and cholesterol, and how they contribute to assessing metabolic risk. Finally, Jessica discusses the role of serial LFT monitoring in evaluating treatment response—highlighting what it means when liver enzyme levels fall and why "normal" LFTs don’t always indicate disease resolution. Whether you're a primary care provider or hepatology specialist, this podcast offers valuable guidance for early detection, risk stratification, and longitudinal monitoring of patients with MASH.
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MASLD Pharmacotherapy With Patrick Horne
September 2025
Join Patrick Horne, NP for a clear, clinic-ready overview of MASLD/MASH pharmacology—from the lifestyle backbone to cardiometabolic risk reduction and liver-directed therapies. Patrick breaks down where GLP-1 receptor agonists fit, reviews evidence and patient selection for vitamin E and pioglitazone, and spotlights resmetirom—the first FDA-approved THR-β agonist for non-cirrhotic MASH with F2–F3 fibrosis—including mechanism, key MAESTRO-NASH outcomes, common AEs (nausea/diarrhea), and practical drug–drug interactions. Walk away with a step-by-step approach to selecting therapy, setting measurable lifestyle goals, and using NITs to monitor response and guide duration—so you can confidently tailor treatment and improve outcomes.
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MASLD Pharmacotherapy With Summer Collier
August 2025
Join Summer Collier, FNP, from UC San Diego Health, for a comprehensive discussion on pharmacotherapy for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH, presented through the GHAPP MASLD/MASH Community Network and sponsored by Madrigal Pharmaceuticals. In this session, Summer outlines the foundational role of lifestyle modification in treating MASLD, including diet, exercise, and weight loss, while emphasizing the growing need for liver-directed therapies in patients with moderate to advanced fibrosis. She reviews the clinical use of GLP-1 receptor agonists such as semaglutide and tirzepatide, which aid in glycemic control and significant weight loss, and explores their application in hepatology—including key data showing MASH resolution and fibrosis improvement. The discussion also addresses older treatment options like vitamin E and pioglitazone, explaining their risks, limitations, and patient selection criteria. The highlight of the presentation is a detailed analysis of resmetirom (Rezdiffra)—the first FDA-approved therapy for non-cirrhotic NASH with F2–F3 fibrosis. Summer walks through the MAESTRO-NASH trial, covering the mechanism of THR-β activation, improvements in liver histology, safety data, and practical prescribing guidance, including non-invasive monitoring, statin dose considerations, and drug–drug interactions. The session concludes with expert insights on staging, treatment duration, insurance access, and the evolving future of MASLD therapy. A must-watch for hepatology, GI, and primary care providers seeking to implement the latest evidence-based approaches in managing fatty liver disease.
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MASLD Basics With Chantil Jeffreys
September 2025
In this MASLD/MASH Community Network “Basics” session, Chantil Jeffreys, NP clarifies the new MASLD/MASH nomenclature, how to recognize metabolic criteria (obesity, dyslipidemia, hypertension, impaired glucose/A1C, low HDL), and when to rule out other causes (alcohol overlap, DILI, cryptogenic disease). She walks through a practical primary-care workflow: start with FIB-4, then risk-stratify with FibroScan or ELF, identify patients who need hepatology referral, and decide when liver biopsy is appropriate (discordant/indeterminate NITs, suspected concomitant disease, select older patients). The talk covers global prevalence, natural history and progression (F0→F4/cirrhosis→HCC), and why aggressive cardiometabolic risk reduction and appropriate surveillance matter. You’ll leave with a clear algorithm to stage disease, monitor over time, and communicate the MASLD/MASH shift to colleagues and patients.
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PCP Screening for MASH/MASLD: Identifying At-Risk Patients
July 2025
In this episode, Jeremy Davis, NP from Gastrointestinal Specialists in Shreveport, Louisiana, discusses the vital role of primary care screening for MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH (metabolic-associated steatohepatitis). With the rising prevalence of metabolic co-morbidities like type 2 diabetes, hypertension, dyslipidemia, and obesity, early identification of at-risk patients is more critical than ever. Jeremy outlines practical and evidence-based strategies for screening in the primary care setting, starting with simple tools like the FIB-4 score—which relies on common lab values—and how to interpret results to guide referrals to hepatology or GI specialists. He also discusses the downstream workup upon referral, including non-invasive tests like FibroScan, ELF score, and liver ultrasound. Treatment fundamentals such as the Mediterranean diet, physical activity, and weight loss remain the cornerstone of care, while emerging therapies like GLP-1 agonists and resmetirom offer new options for high-risk patients. Whether you’re a PCP, APP, or specialist, this episode offers clear guidance on how to incorporate MASLD screening into everyday workflows to catch liver disease early and optimize outcomes.
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Lifestyle Management With Becky Klemme
September 2025
In this educational session, Becky Klemme, NP from Sioux Falls, South Dakota, shares over a decade of hepatology experience to highlight lifestyle management for patients with Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD). Formerly known as NAFLD, MASLD is now the most common chronic liver disease worldwide, closely linked to obesity, type 2 diabetes, hypertension, and cardiovascular disease. Through a detailed patient case, Becky explains how to evaluate MASLD using labs, imaging, and non-invasive tests like FIB-4 and FibroScan, and how to distinguish between simple steatosis, steatohepatitis (MASH), and advanced fibrosis. She outlines practical strategies for dietary changes, exercise, weight loss goals, and metabolic risk reduction—all while keeping patient-centered, culturally sensitive care in mind. Viewers will also learn about the pathogenesis of MASLD and MASH, the role of genetics and lifestyle, and evidence-based approaches such as the Mediterranean diet, structured physical activity, behavioral counseling, and the 5A framework for patient engagement. With obesity and diabetes on the rise, early recognition and proactive lifestyle intervention are essential to preventing progression to cirrhosis, liver failure, or hepatocellular carcinoma (HCC). If you are a hepatology provider, APP, or clinician managing patients with fatty liver disease, this session offers actionable insights and patient care strategies you can use in practice.
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MASLD vs MetALD With Janet Gripshover
September 2025
Janet Gripshover, NP, explains how to spot and manage metabolic dysfunction–associated steatotic liver disease (MASLD) and MASH—now the preferred terms replacing NAFLD. Through a real patient case, she shows how ultrasound findings, everyday risk factors (PCOS, high blood pressure, cholesterol, higher BMI), and an honest alcohol history point the way. Janet covers easy, non-invasive tests (FIB-4 blood test, FibroScan® stiffness and CAP scores) and when alcohol biomarkers (PEth, urine EtG) help confirm what’s really driving the liver damage. You’ll learn simple next steps: Mediterranean-style eating, resistance exercise, weight loss goals, and complete alcohol cessation to prevent progression to cirrhosis. She also notes when to start liver cancer (HCC) screening and what to document in the chart. Perfect for APPs and clinicians looking for a clear, practical MASLD/MASH workflow.
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