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MASLD AI 01:48 AM
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.
Related Podcast
MASLD Basics With Scott Springer
August 2025
Welcome to the GHAPP MASLD Community Network, where Scott Springer, PA-C, from Erie County Medical Center in Buffalo, NY, provides a comprehensive overview of the evolving landscape of steatotic liver disease. Sponsored by Madrigal Pharmaceuticals, this session breaks down the recent nomenclature shift from NAFLD/NASH to MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction-Associated Steatohepatitis). Scott explores how overlapping etiologies like alcohol-associated liver disease (ALD) and the emerging classification of MetALD better reflect real-world patient populations. Learn about key diagnostic strategies—including the use of FIB-4, ELF score, and transient elastography—to assess fibrosis risk and guide referral to hepatology care. With a clinical case study, Scott highlights the importance of accurate staging, ruling out alternative etiologies, and understanding progression rates in high-risk patients. This session is a must-watch for GI and hepatology APPs looking to stay updated on guidelines, non-invasive diagnostics, and best practices for managing MASLD/MASH in primary and specialty settings.
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Practical Techniques for Lifestyle Adherence
July 2025
In this episode, Emily Przybyl, PA-C at Erie County Medical Center in Buffalo, NY, dives into the foundations of motivational interviewing for patients with MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH. With practical, real-world insights from her clinical experience, Emily shares how providers can build trust, meet patients where they are, and guide them toward meaningful, sustainable lifestyle changes. She emphasizes asking open-ended questions, assessing social determinants of health like income and food access, and collaboratively developing realistic diet and exercise plans tailored to each patient’s circumstances. Emily also highlights culturally sensitive counseling techniques, strategies for overcoming barriers like limited mobility or unsafe environments, and the importance of setting SMART goals for weight loss and liver health. Whether patients are struggling with motivation, resistant to change, or unsure where to start, this episode provides a supportive, patient-centered framework for fostering long-term behavior change in metabolic liver disease.
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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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MASLD Pharmacotherapy With Elizabeth Alqueza
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.
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Differentiating Between F3 and F4
July 2025
In this comprehensive discussion, HoChong Gilles, a nurse practitioner with 25 years of hepatology experience at the Richmond VA Medical Center, explores the critical importance of accurately distinguishing between F3 (advanced fibrosis) and F4 (cirrhosis) in patients with MASH (metabolic-associated steatohepatitis). While both stages carry increased risks of liver-specific and overall mortality, Gilles explains that F3 may still be reversible with lifestyle changes or pharmacotherapy, whereas F4 signals irreversible liver damage with heightened risk of complications like portal hypertension, hepatic encephalopathy, and liver cancer. Viewers will gain a deeper understanding of how non-invasive tests—like FIB-4, ELF, FibroScan, and MRE—perform in identifying fibrosis stage, including their limitations and overlaps. Gilles also outlines when to consider liver biopsy, especially in cases with discordant test results, atypical features, or clinical uncertainty. This video emphasizes how staging accuracy informs eligibility for therapies, surveillance strategies like HCC screening, and overall prognosis. Learn how to approach this nuanced distinction in clinical practice and why F3 vs. F4 isn't just semantics—it's a turning point in patient care.
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MASLD Pharmacotherapy With Jordan Mayberry
July 2025
Join Jordan Mayberry, MPAS, PA-C from UT Southwestern, for an insightful session from the GHAPP MASLD/MASH Community Network focused on the evolving landscape of pharmacotherapy in MASLD and MASH. This presentation explores evidence-based strategies for treating metabolic dysfunction–associated steatotic liver disease (MASLD), with an emphasis on weight loss, diabetes management, and liver-directed therapies. Jordan breaks down key data on GLP-1 receptor agonists, SGLT2 inhibitors, Vitamin E, pioglitazone, and highlights the latest clinical evidence supporting the use of Resmetirom—the first FDA-approved treatment for MASH with stage 2 or 3 fibrosis. Learn how these therapies fit into hepatology practice, including clinical considerations, side effect management, and patient selection. Stay up to date on ongoing research, treatment duration, and real-world application of these new therapies. Don’t forget to register and join the GHAPP MASLD/MASH Community Network for continued education and access to valuable resources.
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Podcast: Role of Exercise in Liver Health
June 2025
In this engaging episode of the GHAPP MASLD/MASH Community Network podcast, Jonathan Yeh, PA at Columbia University Medical Center, discusses the essential role of exercise in liver health—especially in managing MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). With over 14 years of hepatology experience, Jonathan breaks down the most effective types of physical activity, highlighting the benefits of combining aerobic and resistance training over high-intensity interval training (HIIT) alone. He provides practical, personalized exercise recommendations tailored to patients’ physical abilities, access to resources, and comorbidities—including suggestions for those with mobility limitations or time constraints. Jonathan also offers motivational strategies to help patients overcome common barriers such as lack of time, motivation, or access to fitness facilities. From parking farther from a destination to lunchtime walks and home-based workouts using resistance bands, he emphasizes creative and realistic ways to build physical activity into daily routines. Beyond weight loss, he explains how exercise directly improves liver function by reducing liver fat, enhancing insulin sensitivity, and preventing fat and sugar buildup in the liver. This episode is a must-watch for clinicians and patients alike seeking to understand and implement exercise as a cornerstone in the management of fatty liver disease.
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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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Lifestyle Management With Milly Ng
August 2025
Join Milly Ng, NP, a hepatology nurse practitioner at Tufts Medical Center in Boston, for an evidence-based session on lifestyle management for MASLD and MASH, presented through the GHAPP MASLD Community Network and sponsored by Madrigal Pharmaceuticals. Through the case of "Albert," a patient with steatosis and metabolic risk factors, Milly highlights the importance of personalized counseling and non-invasive testing like FIB-4 and FibroScan to assess fibrosis risk. She reviews how Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and its progressive form, MASH, can be reversed through diet, exercise, and weight loss, particularly before fibrosis advances to cirrhosis. Learn how to tailor dietary guidance to a patient's cultural background, socioeconomic status, and personal goals, and understand how central obesity and insulin resistance drive disease progression. Milly also reviews the genetic and environmental factors influencing steatosis, why aerobic training may be more effective than resistance workouts for liver health, and how validated tools like the EDAS (Exercise and Diet Adherence Scale) can track patient progress. This session empowers primary care and hepatology providers to deliver patient-centered lifestyle interventions that can prevent liver disease progression and reduce cardiometabolic risk.
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Non-Invasive Testing With Patrick Horne
September 2025
In this case-based session, Patrick Horne, NP speaks about non-invasive testing (NITs) to stage MASLD/MASH without biopsy. Starting from a real patient, he shows how to triage with FIB-4, then advance to liver stiffness measurement—FibroScan/VCTE (kPa for fibrosis, CAP for steatosis)—and when to add ELF, MRE, and MRI-PDFF. You’ll learn which results flag advanced fibrosis vs. low risk, how to vet scan quality (≥10 valid measurements, clean parallel shear waves, acceptable IQR/median), and the common confounders that can inflate stiffness. Patrick maps decisions to AGA/AASLD-aligned pathways for referral, monitoring, and re-staging—and applies the algorithm to the case.
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