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September 2025
Join Jill Olmstead, DNP from Providence Health in Southern California for a step-by-step guide on working up patients with elevated liver enzymes in this MASLD & MASH Community Network podcast. Jill reviews how to distinguish acute vs. chronic liver injury, interpret patterns of hepatocellular vs. cholestatic damage, and order the right serologic tests, including viral hepatitis panels, autoimmune markers (ANA, ASMA, AMA), Wilson’s disease, alpha-1 antitrypsin deficiency, iron studies, and celiac screening. She highlights common causes such as alcohol use and MASLD—now one of the leading causes of liver transplantation—and explains when to use abdominal ultrasound, MRCP, or ERCP to assess for gallstones, biliary obstruction, or sludge. Jill also emphasizes the role of noninvasive fibrosis assessment (FIB-4 score, FibroScan®, fibrosis panels) in staging and treatment planning. With practical insights on history taking, medication review, alcohol counseling, and referral thresholds, this episode provides APPs, GI providers, and hepatology clinicians with a clear framework to evaluate and manage patients with abnormal liver tests and protect long-term liver health.
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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Comparing F3 and F4 Fibrosis With Erin Parkinson
July 2025
In this in-depth clinical discussion, Erin Parkinson, NP from the Tampa General Medical Group Transplant Institute, walks through the nuanced process of differentiating stage 3 and stage 4 fibrosis in patients with MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease). Using two illustrative case studies, she explores key clinical signs, lab values, and non-invasive staging tools such as FibroScan, FIB-4, ELF score, and MR elastography. Parkinson discusses the importance of early identification of advanced fibrosis, the reversibility of stage 3 disease, and the implications of a diagnosis of cirrhosis. Erin outlines evidence-based treatment pathways including lifestyle interventions, use of GLP-1 receptor agonists, and initiation of resmetirom (Rezdiffra) for stage 2–3 fibrosis. For cirrhotic patients, the focus shifts to HCC surveillance, screening for clinically significant portal hypertension, and consideration of non-selective beta blockers like carvedilol. This video offers practical insights for hepatology providers navigating the evolving MASLD landscape and highlights how early intervention and accurate staging can impact long-term outcomes.
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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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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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APP Insight: Common Questions from Patients About MASH
June 2025
In this video, Jonathan Yeh, PA, answers three of the most frequently asked questions about MASH—Metabolic Dysfunction–Associated Steatohepatitis—and offers practical advice for understanding and managing this progressive form of fatty liver disease. He begins by explaining what MASH is: an inflammatory, more advanced stage of MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease), driven by abnormal fat accumulation in the liver due to impaired fat transport. Jonathan then breaks down the treatment approach, emphasizing the importance of lifestyle modification—particularly diet and exercise. He highlights the benefits of a green Mediterranean diet, regular physical activity, and sustainable weight loss, which can improve or even reverse MASH in many patients. For individuals with more advanced fibrosis, pharmacologic treatment with resmetirom (Rezdiffra) may be indicated. This concise FAQ offers helpful guidance for patients and providers alike on tackling MASH with evidence-based strategies.
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Non-Invasive Testing With Erin Tanner
July 2025
In this educational session from the GHAPP MASLD & MASH Community Network, Erin Tanner, PA-C from Gastro Health in Birmingham, Alabama, presents a practical overview of non-invasive testing (NIT) options for evaluating and managing MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). Using a patient case study, Erin explores how clinicians can effectively utilize tools like FIB-4, FibroScan® (VCTE and CAP), ELF, MRE, and other emerging imaging and serum biomarkers to assess hepatic steatosis and fibrosis without the need for liver biopsy. The talk breaks down the pros, cons, and clinical accuracy of various NITs—including shear wave elastography, MRI-PDFF, and proprietary serum markers—and offers guidance on how to apply these tools in real-world hepatology and primary care settings. Special attention is given to identifying patients with metabolic risk factors, interpreting indeterminate FIB-4 scores, and knowing when to refer patients for further hepatology evaluation. Whether you’re new to liver disease management or looking to update your MASLD/MASH care pathways, this session offers clarity on how to stratify fibrosis risk and make informed clinical decisions using non-invasive diagnostics.
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MASLD Pharmacotherapy With Jeremy Davis
September 2025
In this clinician-focused talk, Jeremy Davis, NP, delivers a clear, practical guide to MASLD/MASH pharmacotherapy—from foundational lifestyle and weight-loss strategies to medications that move the needle. He reviews the role of GLP-1 receptor agonists (and emerging dual agonists) for weight reduction and glycemic control, peri-procedure considerations (delayed gastric emptying/aspiration risk), and where legacy options like vitamin E (select non-diabetic, non-cirrhotic patients) and pioglitazone fit, including benefits and safety trade-offs. The session spotlights resmetirom—the first FDA-approved, liver-directed THR-β agonist for non-cirrhotic MASH with F2–F3 fibrosis—covering its mechanism, key MAESTRO-NASH data, common AEs (nausea/diarrhea), and practical drug–drug interaction/statin-dosing considerations. You’ll also learn how to structure follow-up with non-invasive testing (FibroScan kPa/CAP, ELF, labs), set measurable lifestyle goals, coordinate cardiometabolic risk reduction (T2D, hypertension, dyslipidemia), and navigate coverage and duration questions—so you can confidently tailor therapy and improve outcomes across the MASLD/MASH spectrum.
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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 Pharmacotherapy With Christina Hanson
September 2025
Learn about the latest advances in MASLD and MASH pharmacotherapy in this educational session from the GHAPP MASLD Community Network. Christina Hanson, NP, reviews the evolving landscape of treatment for metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH), including the critical role of weight loss, cardiovascular risk reduction, and liver-directed therapies. The discussion covers current management strategies such as GLP-1 receptor agonists, bariatric interventions, statins, and lifestyle modification, while also exploring guideline-supported options like vitamin E and pioglitazone. Special attention is given to the first FDA-approved therapy for MASH, Resmetirom, including its mechanism, clinical trial results, safety considerations, and monitoring recommendations. Whether you are a hepatology specialist, primary care provider, endocrinologist, or advanced practice provider, this session highlights practical approaches to managing patients with MASLD and MASH and offers insights into emerging therapies that may shape future clinical practice.
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Comparing F3 and F4 Fibrosis With Allysa Saggese
September 2025
In this session from the MASLD/MASH Community Network, Allysa Saggese, NP from Weill Cornell Medicine in New York, explores the critical differences between F3 and F4 fibrosis through two detailed case studies. Accurate staging is essential in fatty liver disease management, as it directly impacts treatment decisions, eligibility for FDA-approved therapies like resmetirom, and the need for hepatocellular carcinoma (HCC) surveillance. Allysa explains how non-invasive tests such as FIB-4, FibroScan, ELF, CAP, and MRI elastography compare, when to consider a liver biopsy, and how to interpret discordant results. She also discusses treatment pathways, the role of GLP-1 receptor agonists, lifestyle modification, and monitoring strategies for patients with advanced fibrosis versus cirrhosis. This practical overview provides clinicians with a clear framework to distinguish between F3 and F4, ensuring patients receive timely interventions, surveillance, and education to improve long-term outcomes in MASLD/MASH.
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