
Summer Collier
MSN, FNP-BC
Location : San Diego, CA, USA

BIO
Summer Collier is a nurse practitioner with advanced expertise in hepatology and a strong commitment to evidence-based, multidisciplinary care. At UC San Diego Health, she provides comprehensive management for patients with chronic liver disease, including viral hepatitis, autoimmune hepatitis, alcohol-associated liver disease, and metabolic dysfunction–associated steatotic liver disease (MASLD).
Collier is actively engaged in clinical research and has participated in multidisciplinary studies on liver fibrosis, steatosis, and treatment protocols for hepatitis C and alcohol use disorder. Her scholarly work focuses on improving transitions of care for patients with cirrhosis and expanding access to pharmacologic treatments for patients with alcohol use disorder.
A recognized leader in the field, Collier has presented at national conferences including The Liver Meeting (AASLD), Digestive Disease Week (DDW), and GHAPP, speaking on topics such as cirrhosis care, hepatology red flags, and advanced practice provider leadership. She previously served as Chair of the Advanced Practice Council at UC San Diego Health, driving initiatives that elevated APP visibility and impact within the organization.
Before joining UC San Diego Health, she was a family nurse practitioner and HIV specialist with Family Health Centers of San Diego. She also has prior experience as a registered nurse.
Collier completed a Master of Science in Nursing degree from University of San Diego and will complete the Doctor of Nursing Practice degree from University of California, Los Angeles in June 2025. She is certified by the American Nurses Credentialing Center.
MASLD-MASH Content Featuring Summer

Clinical Deep Dive: Unlocking the Treatment Potential of Rezdiffra
March 2025
This educational discussion dives into Rezdiffra, the first and only FDA-approved therapy for non-cirrhotic metabolic-associated steatohepatitis (MASH) with moderate to advanced fibrosis. The talk provides a clinical deep dive into the progression of MASH and fibrosis, highlighting the risks of untreated disease and the importance of early intervention. A key focus is the thyroid hormone receptor beta mechanism, explaining how Rezdiffra directly targets liver-specific pathways to reduce hepatic fat accumulation and fibrosis. Additionally, the discussion covers the rigorous FDA approval process and dual efficacy endpoints, detailing how Rezdiffra achieved significant fibrosis improvement and steatohepatitis resolution in the MAESTRO-NASH trial. The session also provides practical insights into patient access, prescribing considerations, and managing common side effects. With over 2,000 patients studied, Rezdiffra has demonstrated a strong safety profile and offers a once-daily oral treatment option that represents a major advancement in MASH management. This discussion is essential for gastroenterologists, hepatologists, and endocrinologists managing patients with MASH, as well as primary care providers and cardiologists who play a role in identifying at-risk individuals. If you are a healthcare professional looking to stay updated on the latest MASH research and treatment strategies, this session provides the insights you need.
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MASLD Basics With Jill Olmstead
August 2025
Join Jill Olmstead, NP, a seasoned gastroenterology nurse practitioner from Providence St. Joseph Health, for an in-depth overview of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Steatohepatitis) in this GHAPP MASLD Community Network presentation, proudly sponsored by Madrigal Pharmaceuticals. With over 20 years of clinical experience, Jill explains the evolving nomenclature from NAFLD/NASH to MASLD/MASH and how this impacts diagnostic criteria, patient communication, and multidisciplinary management. Learn how to identify steatotic liver disease, assess cardiometabolic risk factors, and use tools like FIB-4 and FibroScan to evaluate fibrosis and stratify risk. Jill walks through real-world case scenarios, highlighting when to order a liver biopsy, when to refer to hepatology, and how to apply AASLD guidelines in clinical practice. From evaluating elevated liver enzymes to addressing the global burden of MASLD and its progression to cirrhosis and HCC, this session is essential for providers navigating the complexities of modern liver disease management in both primary care and specialty settings.
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MASLD Basics With Valerie Shin
August 2025
Join Valerie Shin, NP, from the Fatty Liver Institute at UCLA, for a foundational discussion in the GHAPP MASLD Community Network, sponsored by Madrigal Pharmaceuticals. This educational session covers the basics of steatotic liver disease (SLD), with a special focus on the evolving terminology and diagnostic criteria surrounding MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Steatohepatitis). Valerie explains why the shift away from the outdated “fatty liver” label is more than semantics—it removes stigma, increases diagnostic precision, and improves patient-provider communication. Through clear visuals and case-based discussion, this presentation outlines the global epidemiology of MASLD, how to classify disease etiology (MASLD, MetALD, ALD, or other rare causes), and how to risk-stratify patients using non-invasive tools like FIB-4, FibroScan, and ELF. Learn how to diagnose MASLD, when to refer to hepatology, how to use biomarkers for staging fibrosis, and when pharmacotherapy like resmetirom may be appropriate. With rising global prevalence and many patients progressing silently to cirrhosis or HCC, early detection and management are key. Don’t miss this practical, clinically grounded presentation designed for APPs and primary care providers managing patients with metabolic liver disease.
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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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Non-Invasive Testing With Kelly Smeester
August 2025
Join Kelly Smeester, MMS, RD, PA-C, from South Denver Gastroenterology, for an in-depth discussion on the latest tools and strategies in non-invasive liver disease assessment, presented through the GHAPP MASLD Community Network. This evidence-based session walks viewers through a case study of a patient with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and explores the full range of non-invasive testing modalities used to evaluate liver fat, stiffness, and fibrosis risk. Kelly breaks down the utility of key tests including FIB-4, ELF Score, FibroScan (VCTE), and MR Elastography, and compares their accuracy, accessibility, limitations, and clinical value. Learn how to interpret biomarkers such as CAP (Controlled Attenuation Parameter) and kPa (Kilopascals), how to navigate indeterminate FIB-4 results, and when to escalate to more advanced imaging like MRE. The session also provides insights into combined scoring models (FAST, MAST, MEFIB), real-world use cases, and how comorbidities and patient-specific factors (BMI, ALT, bilirubin, ascites) can impact test reliability. Whether you're managing early-stage fatty liver disease or advanced fibrosis, this session provides essential knowledge to guide accurate diagnosis, risk stratification, and long-term monitoring without a liver biopsy.
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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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MASLD Pharmacotherapy
July 2025
In this dynamic and highly informative session, Sherona Bau, NP, presents a comprehensive overview of pharmacotherapy in MASLD and MASH, breaking down current treatment strategies and emerging therapies for patients with metabolic dysfunction-associated steatotic liver disease. This presentation, part of the MASLD/MASH Community Network, begins by contextualizing the recent nomenclature shift from NAFLD/NASH to MASLD/MASH and its clinical implications. Sherona explores lifestyle intervention targets, including Mediterranean diet, weight loss goals based on fibrosis stage, and the role of GLP-1 and GIP receptor agonists in improving liver health. She highlights the ESSENCE trial results for semaglutide, discusses the only FDA-approved therapy to date—resmetirom (Rezdiffra)—and explains its mechanism of action via thyroid hormone receptor beta activation. The session dives deep into efficacy data from the MAESTRO-NASH trial, side effect profiles, drug–drug interactions, and monitoring recommendations. She also previews a pipeline of promising agents in phase 2 and 3 trials—including tirzepatide (GLP-1/GIP), cotadutide (GLP-1/GR), pemvidutide (GLP-1/GIP), and retatrutide (GLP-1/GIP/GR)—offering insight into what’s next in the evolving treatment landscape. This is a must-watch for hepatology and endocrinology clinicians focused on the future of fatty liver management.
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Comparing F3 and F4 Fibrosis With Edith Johannes
July 2025
Join Edith Johannes, NP from UCLA Health, for a comprehensive and approachable introduction to MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease)—formerly known as NAFLD—and how to accurately diagnose it. Designed for primary care providers and early learners in hepatology, this session outlines the fundamental criteria for diagnosing MASLD and MASH, the importance of ruling out alternate causes of hepatic steatosis, and the key role of cardio-metabolic risk factors. Edith discusses how to apply non-invasive testing tools such as the FIB-4 score, ELF test, and elastography to determine fibrosis stage, along with guidance on when to consider liver biopsy and refer to hepatology. The presentation also explores the overlap between MASLD and alcohol-related liver disease, addresses the impact of genetic risk factors like PNPLA3 (particularly in Hispanic populations), and reinforces the urgent need for early detection to prevent cirrhosis and liver cancer. With clinical pearls and case-based examples, this session helps clinicians feel confident in evaluating patients for MASLD and navigating next steps for care.
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Non-Invasive Testing With Sherona Bau
July 2025
In this engaging and highly informative GHAPP MASLD Community Network session, Sherona Bau, PA-C, walks attendees through a practical overview of non-invasive testing (NIT) for evaluating liver health in patients with MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). Drawing on real-world clinical experience, Sherona explains why non-invasive testing is essential for identifying fibrosis risk in a population where liver steatosis is prevalent in up to 30% of U.S. adults. Through the case of a 65-year-old Hispanic male named Albert, Sherona demonstrates how to interpret and apply tools such as FIB-4, FibroScan (VCTE and CAP score), ELF (Enhanced Liver Fibrosis) test, and MR Elastography (MRE). She highlights their respective strengths, limitations, clinical cut-offs, and insurance-related considerations. The session also covers when to order tests, how to assess data quality (e.g., IQR/median ratio in VCTE), and when to escalate care to hepatology or cardiology. Whether you are a primary care provider, endocrinologist, or hepatology specialist, this talk delivers practical algorithms and decision-making pathways for managing MASLD, improving early detection of fibrosis and cirrhosis, and integrating cardiovascular risk assessment into liver care. Sherona also emphasizes the importance of alcohol use history, metabolic syndrome risk factors, and annual NIT follow-up in patients at risk for disease progression.
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Comparing F3 and F4 Fibrosis With Lindsay Pratt
July 2025
Join Lindsey Pratt, PA-C from the University of Colorado Liver Transplant Program, for an in-depth clinical comparison of F3 and F4 fibrosis in patients with MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). Using an identical patient profile with differing non-invasive testing results, Lindsey demonstrates how to accurately stage fibrosis using tools like FIB-4, FibroScan, CAP score, and ELF test—emphasizing when pharmacologic intervention is appropriate and when advanced monitoring becomes critical. This session explores the clinical implications of fibrosis staging, treatment pathways including resmetirom (Rezdiffra), the role of GLP-1 receptor agonists, and practical nutrition and lifestyle strategies. For F4 patients, Lindsey outlines key elements of surveillance for hepatocellular carcinoma (HCC), portal hypertension management, and transplant evaluation. Whether you're in hepatology or primary care, this case-based discussion offers evidence-backed guidance for managing patients across the MASLD/MASH spectrum and preventing liver disease progression.
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Comparing F3 and F4 Fibrosis With Robin Soto
July 2025
In this in-depth case-based session from the GHAPP MASLD/MASH Community Network, Robin Soto, NP from UC San Diego Health, explores the clinical nuances of diagnosing and managing fibrosis stage 3 versus stage 4 in patients with MASH (Metabolic Dysfunction–Associated Steatohepatitis). Using a real-world case study of a patient named Sam, Robin demonstrates how to interpret and reconcile non-invasive tests (NITs) like FIB-4, FibroScan, CAP score, and ELF test to guide accurate staging. She offers practical insights into treatment decisions, including when to use resmetirom, the importance of lifestyle modification, and how to assess comorbidities like diabetes, obesity, and cardiovascular risk. The session also outlines when and how to monitor for hepatocellular carcinoma (HCC), implement liver cancer surveillance strategies, and approach multidisciplinary care for advanced fibrosis or cirrhosis. Whether you’re a hepatology specialist or a primary care provider, this video equips you with evidence-based tools for managing MASLD and optimizing outcomes in complex liver disease.
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Comparing F3 and F4 Fibrosis With Michelle Barnett
July 2025
In this installment of the GHAPP MASLD Community Network, Michelle Barnett, PA-C from Peak Gastroenterology in Colorado Springs, presents a deep dive into the clinical management of MASH—formerly known as NASH or non-alcoholic steatohepatitis. Through two comparative case studies, Michelle explores the nuances of diagnosing and managing patients with F3 and F4 fibrosis. Learn how to effectively use non-invasive diagnostic tools like FIB-4, FibroScan, and ELF testing, and gain valuable insights into stratifying fibrosis risk, monitoring hepatocellular carcinoma (HCC), and determining when resmetirom is appropriate. This session also covers practical guidance on nutrition, exercise, medication safety, and multidisciplinary care for patients with advanced liver disease. Whether you're a hepatology specialist or a primary care provider navigating the MASLD/MASH landscape, this video offers actionable strategies to improve long-term patient outcomes and reinforces the critical role of lifestyle intervention and liver disease surveillance.
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Lifestyle Management With Lisa Richards
July 2025
Join Lisa Richards, FNP-BC, from UC San Diego Health, as she leads a powerful educational session on the lifestyle management of MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) in this GHAPP MASLD/MASH Community Network event, sponsored by Madrigal Pharmaceuticals. Through a compelling clinical case study, Lisa walks viewers through a step-by-step approach to diagnosing MASLD, assessing fibrosis risk using noninvasive tools like FIB-4 and FibroScan, and implementing guideline-based interventions. Learn how to counsel patients on culturally sensitive dietary modifications, physical activity strategies, and behavior change techniques that improve outcomes. This session also explores the clinical relevance of weight loss thresholds, Mediterranean-style eating plans, and the importance of patient-centered goal setting. Whether you’re a provider managing metabolic liver disease or looking to integrate newer therapies like resmetirom, this video offers practical tools to empower sustainable change and improve liver health.
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MASLD Basics With Summer Collier
July 2025
Join Summer Collier, NP from UC San Diego Health, for an essential overview of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) in this GHAPP MASLD Community Network session. Designed for clinicians and healthcare professionals, this case-based talk covers the evolving nomenclature shift from NAFLD/NASH to MASLD/MASH, including key definitions, diagnostic criteria, and practical tools for identifying and managing patients with steatotic liver disease. Summer walks through foundational concepts like the role of hepatic steatosis, cardio-metabolic risk factors, and the importance of excluding significant alcohol use to establish a MASLD diagnosis. She also provides clinical insights into non-invasive fibrosis staging using FIB-4, FibroScan, elastography, and blood-based tests, as well as how to differentiate patients who may require hepatology referral or biopsy. Emphasizing the importance of early detection and risk stratification in primary care, this session highlights how fibrosis stage impacts prognosis, treatment planning, and long-term liver-related outcomes. For more educational sessions and MASLD tools — visit the GHAPP MASLD Community Network.
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Management of Life Style Modification
January 2025
This video focuses on the comprehensive management of patients with metabolic-associated steatohepatitis (MASH), emphasizing lifestyle modifications, dietary adjustments, and exercise strategies. Key topics include the importance of addressing risk factors like diet, exercise habits, and alcohol intake, as well as referrals to medically supervised weight loss clinics or bariatric surgery for advanced cases. The speaker highlights the benefits of the Mediterranean diet, intermittent fasting, and avoiding ultra-processed foods while discussing the role of resistance training to combat sarcopenia and maintain muscle mass. Practical advice and tailored recommendations ensure a holistic approach to managing MASH and improving patient outcomes.
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Third Step of Life Style Management
January 2025
This video provides a comprehensive overview of emerging pharmacologic treatments for metabolic-associated steatohepatitis (MASH) and their tailored applications based on patient profiles. Topics include FDA-approved therapies, drugs in advanced clinical trials (such as semaglutide and lanifibranor), and the potential for combination treatments targeting both steatohepatitis and fibrosis. The speaker emphasizes the importance of patient-specific approaches considering metabolic profiles, obesity, and diabetes status, alongside lifestyle interventions. Additionally, the video discusses the evolving interdisciplinary care model and highlights the exciting progress in non-invasive testing and treatment advancements for F2-F3 fibrosis.
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Approved Medication for MASH/NASH
January 2025
This video provides detailed guidance on selecting and monitoring patients for emerging therapies targeting advanced fibrosis (F2-F3) in NASH. Key topics include contraindications for patients with cirrhosis, considerations for concomitant medications, and dose adjustments for statins. The video outlines ideal candidates based on specific thresholds for VCTE, MRE, ELF scores, and other non-invasive tests while emphasizing the importance of ruling out portal hypertension and other liver diseases. It also reviews a stepwise monitoring approach, focusing on tolerability at three months and efficacy assessments at six and twelve months, with an emphasis on histologic and non-invasive test improvements.
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Types of Diet for the Treatment of MASLD
January 2025
This video explores comprehensive strategies for managing metabolic-associated steatohepatitis (MASH), focusing on fibrosis risk stratification, lifestyle modifications, and pharmacologic interventions. Learn about dietary recommendations like the Mediterranean diet, exercise guidelines emphasizing resistance training, and the role of intermittent fasting and processed food avoidance. The video also highlights weight loss targets, diabetes management, and emerging therapies such as GLP-1 receptor agonists and bariatric surgery, all aimed at improving liver health and patient outcomes.
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NITs to Identify High Risk MASH Patients
January 2025
Explore advancements in non-invasive diagnostics and risk stratification for liver fibrosis and MASH. This video highlights tools like FIB-4, transient elastography, and innovative scoring systems (e.g., FAST and Agile) to identify and predict outcomes for high-risk patients. Learn about serum biomarkers, updated guidelines, and the role of lifestyle interventions alongside targeted therapies for managing metabolic risks and advancing care in hepatology.
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Podcast: PCP Screening for MASH/MASLD: Identifying At-Risk Patients
July 2025
In this essential podcast episode from the GHAPP MASLD/MASH Community Network, Summer Collier, NP at UC San Diego Health, dives into the critical role that primary care providers and advanced practice providers play in recognizing and managing MASLD (Metabolic dysfunction-associated steatotic liver disease) and its progressive form, MASH (Metabolic-associated steatohepatitis). With MASLD affecting a growing number of patients—many undiagnosed—Summer walks through practical strategies for early identification, starting with high-risk individuals such as those with type 2 diabetes, obesity, or metabolic syndrome. She highlights the use of the FIB-4 index as a quick, validated, and guideline-recommended first-line screening tool, and explains how to interpret FIB-4 results to stratify risk and determine next steps, including ELF testing, FibroScan®, or referral to GI/hepatology. Summer also offers actionable workflow tips to integrate liver screening into routine primary care, like embedding FIB-4 calculators in EMRs or incorporating assessments into annual diabetes visits. This episode is a must-listen for clinicians seeking to prevent liver fibrosis progression and liver cancer through early, proactive care.
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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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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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Pharmacotherapy Review
July 2025
Join Christina Hanson, FNP-C, from South Denver Gastroenterology, as she provides an in-depth overview of the current pharmacologic treatment landscape for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH). This expert-led session explores the three cornerstones of MASH management—lifestyle and weight loss interventions, cardiovascular risk reduction, and liver-directed therapy—while highlighting the evolving role of GLP-1 receptor agonists and the recent FDA approval of resmetirom, the first medication indicated for adults with MASH and moderate to advanced fibrosis. Christina also discusses clinical trial data from MAESTRO-NASH, reviews historical agents like vitamin E and pioglitazone, and offers practical guidance on patient selection, safety considerations, and monitoring strategies. Whether you’re a GI provider, hepatology specialist, or primary care clinician managing fatty liver disease, this video provides valuable insights into how emerging therapies are shaping the future of MASH treatment.
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Liver Model Overview
July 2025
Join Alison Moe, PA-C with United Digestive, as she walks through a hands-on demonstration using a life-sized liver model to help patients better understand fibrosis and liver disease progression. In this engaging and practical overview, Allison explains how different stages of liver fibrosis—from normal liver to cirrhosis and hepatocellular carcinoma—can be felt and visualized using a segmented anatomical model. She shares how this tool enhances patient education during discussions about non-invasive liver testing, such as FibroScan, CAP scores, FIB-4, ELF testing, and more. Designed to support visual learners and improve comprehension of disease state, this video is a valuable resource for clinicians and patients navigating the complexities of metabolic-associated fatty liver disease (MASLD) and its progression to MASH. Learn how tactile and visual teaching aids can bridge the gap between diagnostics and patient understanding in hepatology care.
Watch NowHighlighted Events

GHAPP Eighth Annual Conference
September 04 @ 12:00 pm - September 06 @ 12:00 pm MDT
About the 2025 GHAPP Conference The GHAPP conference is the only conference specifically designed by advanced practice providers (APPs) for the pur..

MASLD vs MetALD - Virtual
September 24 @ 04:00 pm - 04:30 pm PST
Join Summer Collier, FNP, on September 24, 2025, for a live GHAPP Zoom session focused on the evolving understanding of MASLD (Metabolic Dysfunction-A..

Pacific Northwest GI & Liver Update
October 03 @ 12:00 pm - October 04 @ 12:00 pm PST
The 2025 Pacific Northwest GI and Liver Conference will deliver focused educational updates highlighting clinically relevant advances in the managemen..
Related Content

Clinical Deep Dive: Unlocking the Treatment Potential of Rezdiffra
March 2025
This educational discussion dives into Rezdiffra, the first and only FDA-approved therapy for non-cirrhotic metabolic-associated steatohepatitis (MASH) with moderate to advanced fibrosis. The talk provides a clinical deep dive into the progression of MASH and fibrosis, highlighting the risks of untreated disease and the importance of early intervention. A key focus is the thyroid hormone receptor beta mechanism, explaining how Rezdiffra directly targets liver-specific pathways to reduce hepatic fat accumulation and fibrosis. Additionally, the discussion covers the rigorous FDA approval process and dual efficacy endpoints, detailing how Rezdiffra achieved significant fibrosis improvement and steatohepatitis resolution in the MAESTRO-NASH trial. The session also provides practical insights into patient access, prescribing considerations, and managing common side effects. With over 2,000 patients studied, Rezdiffra has demonstrated a strong safety profile and offers a once-daily oral treatment option that represents a major advancement in MASH management. This discussion is essential for gastroenterologists, hepatologists, and endocrinologists managing patients with MASH, as well as primary care providers and cardiologists who play a role in identifying at-risk individuals. If you are a healthcare professional looking to stay updated on the latest MASH research and treatment strategies, this session provides the insights you need.
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Common Questions From Community GI About MASH
August 2025
In this insightful session, Lavinia Iordache, PA-C—a seasoned hepatology specialist from the University of Miami—answers critical questions from GI providers about the real-world management of patients with suspected advanced fibrosis. With over a decade of experience in both outpatient and inpatient liver care, Lavinia explores when and how to monitor patients with low-risk FIB-4 scores, the evolving role of liver biopsy, and criteria for hepatology referral. She also breaks down current AASLD and EASL recommendations for imaging surveillance in MASLD and MASH patients, particularly the limitations of ultrasound in obese populations and why CT or MRI may be preferred in high-risk individuals. From noninvasive testing timelines to HCC screening strategies, this episode offers clear, practical guidance to support frontline GI providers managing the growing population of MASLD patients.
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Common Questions From Patients About MASH
August 2025
In this engaging episode from the GHAPP MASLD Community Network, Alison Moe shares practical insights into the most common questions patients ask about advanced fibrosis and fatty liver disease. Using a liver model, she explains the stages from normal liver to steatosis, fibrosis, and cirrhosis, emphasizing that with lifestyle modifications—such as weight loss, glycemic control, and now FDA-approved pharmacotherapy—fatty liver disease, including F3 fibrosis, can be reversible. Alison also addresses a critical concern: alcohol consumption. She breaks down how her guidance differs depending on the presence and stage of fibrosis, adhering to strict AASLD guidelines to protect liver health. Whether you're a healthcare provider or a patient looking for clarity, this video offers evidence-based guidance and compassionate answers.
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Common Questions From Community GI About MASH
August 2025
In this educational video, HoChong Gilles, NP—Clinical Program Director at the Central Virginia VA Healthcare System—breaks down practical, non-invasive strategies for evaluating liver fibrosis in community GI and primary care settings. With over 25 years of hepatology experience, she walks through the importance of calculating the FIB-4 score using just four parameters: age, ALT, AST, and platelet count. Learn how to interpret FIB-4 score cutoffs to determine low, indeterminate, or high risk of advanced fibrosis and explore alternative tools like the ELF (Enhanced Liver Fibrosis) test when imaging options are limited. Whether you're a hepatology specialist or a frontline provider, this video offers actionable insights to help bridge the gap in liver care access using guideline-supported lab-based methods.
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Common Questions From Primary Care Providers About MASH
August 2025
Join Sarah Dawkins, NP, for quick and practical insights in this edition of GHAPP MASLD Community Network’s APP Insights. Sarah answers common questions from primary care providers about managing patients with hepatic steatosis on imaging but normal liver tests. She explains when to calculate a FIB-4 score, how to interpret mild ALT/AST abnormalities, and when referral to hepatology is necessary. Learn how to assess risk in patients with diabetes, obesity, or metabolic syndrome, and how to rule out other causes like viral hepatitis, alcohol use, drug-induced liver injury, and iron overload. Sarah emphasizes the importance of lifestyle counseling for low-risk patients and provides a clear framework for primary care providers to confidently monitor and manage MASLD without unnecessary referrals. A must-watch for anyone navigating the "gray zone" of liver diagnostics in everyday practice.
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Discordant NITs: The Gray Zone
August 2025
Join Melissa Franco, PA at the University of Miami, for an in-depth episode of the GHAPP MASLD Community Network podcast focused on discordant non-invasive tests (NITs) and navigating the "gray zone" of liver fibrosis staging. Melissa walks through common real-world scenarios where FIB-4, FibroScan, ultrasound, ELF score, and MR elastography deliver conflicting results—exploring why this happens and how to approach it clinically. Learn how patient factors such as obesity, alcohol use, co-morbidities, medications, and test limitations can impact NIT interpretation. Discover Melissa’s expert strategies for re-evaluating results, when to consider liver biopsy, and how to communicate these complexities with patients. From understanding how false elevations occur to using imaging and labs to confirm or exclude advanced fibrosis, this episode provides a practical and evidence-based approach to staging MASLD and MASH when results don’t align. Whether you're managing metabolic liver disease in hepatology or primary care, this is essential listening for interpreting liver diagnostics in nuanced clinical settings.
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LFTs Demystified: A Practical Guide for APPs
August 2025
Join Maly Tiev, NP at NYU Langone Health, for this essential educational session on demystifying liver function tests (LFTs), brought to you by the GHAPP MASLD Community Network. In this video, Maly explains how to interpret ALT, AST, alkaline phosphatase, GGT, bilirubin, albumin, INR, and platelet counts in the context of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Steatohepatitis). Learn why elevated liver enzymes are not always present in MASH, how to distinguish between different causes of abnormal LFTs—including alcohol-related liver disease, viral hepatitis, and drug-induced liver injury—and how serial LFT monitoring can indicate treatment response or disease progression. Discover the importance of using non-invasive tools for fibrosis risk stratification, the role of platelets as a key marker, and how a deeper understanding of synthetic function tests can help identify cirrhosis earlier. Whether you're a clinician or a patient looking to understand the lab work behind fatty liver disease, this presentation offers practical insights for interpreting LFTs with confidence.
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MASLD Pharmacotherapy With Anthony Derencius
August 2025
Join Anthony Derencius, PA-C, sub-investigator at Pinnacle Clinical Research, for an in-depth, case-based discussion on the pharmacologic management of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Steatohepatitis) in this GHAPP MASLD Community Network presentation. With clinical insights from both hepatology practice and research, Anthony explores the multifactorial approach to managing metabolic liver disease—emphasizing weight loss strategies, GLP-1 receptor agonists, cardiovascular risk reduction, and liver-directed therapies. Learn how medications like semaglutide and tirzepatide play a role in weight loss and glycemic control, and how vitamin E and pioglitazone are still considered under specific circumstances. A major highlight includes the mechanism and clinical data behind resmetirom, the first FDA-approved therapy for MASH with F2–F3 fibrosis. Anthony explains its thyroid hormone receptor β-selectivity, efficacy data from the MAESTRO-NASH trial, real-world safety considerations, drug interactions, and monitoring protocols. This presentation is essential viewing for clinicians managing MASLD and MASH in both community and research settings, offering practical strategies, current guidelines, and a look into the future of liver-specific pharmacotherapy.
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MASLD Basics With Jill Olmstead
August 2025
Join Jill Olmstead, NP, a seasoned gastroenterology nurse practitioner from Providence St. Joseph Health, for an in-depth overview of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Steatohepatitis) in this GHAPP MASLD Community Network presentation, proudly sponsored by Madrigal Pharmaceuticals. With over 20 years of clinical experience, Jill explains the evolving nomenclature from NAFLD/NASH to MASLD/MASH and how this impacts diagnostic criteria, patient communication, and multidisciplinary management. Learn how to identify steatotic liver disease, assess cardiometabolic risk factors, and use tools like FIB-4 and FibroScan to evaluate fibrosis and stratify risk. Jill walks through real-world case scenarios, highlighting when to order a liver biopsy, when to refer to hepatology, and how to apply AASLD guidelines in clinical practice. From evaluating elevated liver enzymes to addressing the global burden of MASLD and its progression to cirrhosis and HCC, this session is essential for providers navigating the complexities of modern liver disease management in both primary care and specialty settings.
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MASLD Basics With Tessa Janovsky
August 2025
Join Tessa Janovsky, PA-C, from Arizona Liver Health, for this foundational session in the GHAPP MASLD Community Network, proudly sponsored by Madrigal Pharmaceuticals. This episode offers a comprehensive overview of the updated nomenclature and clinical approach to steatotic liver disease, covering the transition from NAFLD/NASH to MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction-Associated Steatohepatitis). Tessa breaks down the rationale behind this global reclassification and explains how it improves diagnostic clarity while reducing stigma. You’ll learn how to identify MASLD using cardiometabolic risk factors, apply non-invasive risk stratification tools like FIB-4, FibroScan, and ELF, and determine when to refer patients for hepatology care. She also discusses the natural history of MASLD progression, the risk of cirrhosis and HCC, and the clinical importance of early detection and treatment. Real-world case studies guide providers through assessing common patient presentations, ruling out alternative etiologies, and considering pharmacologic therapy like resmetirom when appropriate. This is an essential watch for APPs, PCPs, and GI providers working to better understand and manage MASLD and MASH in clinical practice.
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MASLD Basics With Valerie Shin
August 2025
Join Valerie Shin, NP, from the Fatty Liver Institute at UCLA, for a foundational discussion in the GHAPP MASLD Community Network, sponsored by Madrigal Pharmaceuticals. This educational session covers the basics of steatotic liver disease (SLD), with a special focus on the evolving terminology and diagnostic criteria surrounding MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Steatohepatitis). Valerie explains why the shift away from the outdated “fatty liver” label is more than semantics—it removes stigma, increases diagnostic precision, and improves patient-provider communication. Through clear visuals and case-based discussion, this presentation outlines the global epidemiology of MASLD, how to classify disease etiology (MASLD, MetALD, ALD, or other rare causes), and how to risk-stratify patients using non-invasive tools like FIB-4, FibroScan, and ELF. Learn how to diagnose MASLD, when to refer to hepatology, how to use biomarkers for staging fibrosis, and when pharmacotherapy like resmetirom may be appropriate. With rising global prevalence and many patients progressing silently to cirrhosis or HCC, early detection and management are key. Don’t miss this practical, clinically grounded presentation designed for APPs and primary care providers managing patients with metabolic liver disease.
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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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MASLD Pharmacotherapy With Brian Lam
August 2025
Join Brian Lam, PA-C, Associate Medical Director of Research at INOVA and Chair of the Global NASH/MASH Council, for an insightful discussion on pharmacotherapy for MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease), also known as fatty liver disease. This episode, part of the GHAPP MASLD Community Network, explores the evolution of treatment options—including GLP-1 receptor agonists like semaglutide and tirzepatide, the antioxidant benefits of vitamin E, the metabolic impact of pioglitazone, and the targeted liver-specific mechanism of action of Resmetirom (a THR-β agonist). Learn how weight loss remains a foundational strategy for MASH management, but with FDA approval of new agents like Resmetirom in March 2024, we now have more tools to address hepatic inflammation and fibrosis directly. Brian also shares practical considerations around comorbidities, cardiovascular risk, statin use, and how to evaluate appropriate patients using non-invasive testing like transient elastography and MR elastography. Whether you're new to managing fatty liver or an experienced hepatology APP, this overview provides the latest guidance and clinical insight to improve patient outcomes in MASLD and MASH care.
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Lifestyle Management With Sarah Dawkins
August 2025
Join Sarah Dawkins, NP, for an in-depth and inspiring conversation on lifestyle management for MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction-Associated Steatohepatitis), presented through the GHAPP MASLD Community Network and sponsored by Madrigal Pharmaceuticals. In this engaging session, Sarah uses the real-world case of "Albert" to explore how to assess fibrosis risk using non-invasive testing like FIB-4 and FibroScan, and why lifestyle interventions remain the cornerstone of care for patients without advanced fibrosis. Through a patient-centered lens, she outlines practical strategies for addressing dietary counseling, exercise goals, and culturally sensitive approaches to nutrition—highlighting how individualized care, family involvement, and positive reinforcement can create meaningful behavior change. The session dives into the science behind genetic risk factors like PNPLA3, the role of central obesity in inflammation, and the impact of Western diets on liver health. Sarah also reviews the Mediterranean diet, exercise recommendations, and evidence-based interventions, including the benefits of aerobic + resistance training over HIIT for MASLD improvement. With clinical pearls on motivational interviewing, overcoming barriers to access, and the use of tools like the Exercise and Diet Adherence Scale (EDAS), this session empowers providers to make lifestyle conversations impactful—even when time is short.
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MASLD Basics With Melissa Franco
August 2025
Join Melissa Franco, PA-C, from the University of Miami for a comprehensive review of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and the 2023 nomenclature updates replacing NAFLD and NASH. Presented through the GHAPP MASLD Community Network and sponsored by Madrigal Pharmaceuticals, this session covers the spectrum of steatotic liver disease, including MASLD, MASH, MetALD, alcohol-related liver disease (ALD), and other causes of hepatic steatosis. Learn how to diagnose MASLD using imaging, cardiometabolic risk criteria, and how to exclude other causes like alcohol use, medications, and genetic disorders. Melissa explains how to risk stratify patients using FIB-4, FibroScan, and ELF testing, and when to consider referral to hepatology, especially for patients at intermediate or high risk for advanced fibrosis. The talk also explores global prevalence, natural history, disease progression to cirrhosis and HCC, and highlights the importance of identifying and managing patients with F2–F4 fibrosis, now classified as at-risk MASH. Through a real-world case study, viewers are guided on how to perform a thorough MASLD workup and assess patients for pharmacotherapy, lifestyle counseling, and surveillance protocols. Whether you are in primary care, GI, or endocrinology, this session is an essential resource for early diagnosis and comprehensive management of fatty liver disease in today’s clinical practice.
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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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MASLD Basics With Maribeth Capuno
August 2025
Join us for an in-depth overview of steatotic liver disease, presented through the GHAPP MASLD/MASH Community Network and proudly sponsored by Madrigal Pharmaceuticals. This engaging session walks through the updated terminology replacing NAFLD and NASH with MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction-Associated Steatohepatitis)—explaining what the name change means and how to apply the latest AASLD 2023 guidelines in clinical practice. Learn how to identify MASLD based on cardiometabolic risk factors, rule out other causes of steatosis such as alcohol use, autoimmune conditions, and hereditary liver diseases, and determine when to use non-invasive testing like FIB-4, FibroScan, and ELF to stratify fibrosis risk. With Global Fatty Liver Day around the corner, this timely presentation also highlights the global burden of MASLD, its progression from steatosis to cirrhosis and HCC, and practical steps for primary care and hepatology teams to intervene early. You'll follow the case of JP, a 55-year-old with obesity, pre-diabetes, and elevated liver enzymes, as a real-world example of how to evaluate, diagnose, and manage MASLD—and when to refer to hepatology for advanced care. Whether you're a GI provider, APP, or primary care clinician, this talk offers a practical roadmap for managing fatty liver disease in 2025 and beyond.
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Comparing F3 and F4 Fibrosis With Scott Springer
August 2025
Join Scott Springer, PA-C, from Erie County Medical Center in Buffalo, NY, for a case-based clinical discussion on how to evaluate and manage F3 vs. F4 fibrosis in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH, presented through the GHAPP MASLD/MASH Community Network and sponsored by Madrigal Pharmaceuticals. Using a detailed side-by-side comparison of a fictional patient "Sam," Scott demonstrates how to interpret key non-invasive testing modalities—including FIB-4, ELF, and FibroScan—to stage liver fibrosis, determine candidacy for emerging therapies like resmetirom (Rezdiffra), and identify when liver biopsy may still be necessary. Learn how changes in platelet count, ELF score, and liver stiffness (kPa) help distinguish advanced fibrosis (F3) from cirrhosis (F4) and how this affects treatment decisions, HCC surveillance, and portal hypertension management. Scott also emphasizes the role of GLP-1 therapy, aggressive cardiometabolic risk reduction, and lifestyle counseling as core strategies in MASLD care. This session is a practical guide for GI and hepatology providers navigating MASLD staging, treatment eligibility, and long-term monitoring in 2025 and beyond.
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Comparing F3 and F4 Fibrosis With Maribeth Capuno
August 2025
Join Maribeth Capuno, DNP, from the Richmond VA Medical Center, for an insightful case-based discussion on F3 vs. F4 fibrosis staging in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH, presented through the GHAPP MASLD/MASH Community Network and sponsored by Madrigal Pharmaceuticals. Using the fictional case of “Sam,” Maribeth demonstrates how to differentiate between F3 and F4 fibrosis using non-invasive tools like FIB-4, FibroScan, and the ELF test, while explaining their respective cutoffs and clinical implications. Learn how to stage MASLD accurately, when to consider MRI elastography or liver biopsy, and how to initiate evidence-based management strategies including lifestyle modification, GLP-1 therapy, and the newly approved medication Resmetirom (Rezdiffra). The session highlights the importance of HCC surveillance, portal hypertension screening, and the nuances in monitoring between F3 and F4 fibrosis stages. With a strong emphasis on practical, guideline-aligned hepatology care, this video provides essential insights for clinicians managing the growing MASLD population.
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Comparing F3 and F4 Fibrosis With Jessica Crimaldi
August 2025
Join Jessica Crimaldi, NP, from the Cleveland Clinic, for an in-depth and practical overview of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease), presented through the GHAPP MASLD Community Network and supported by Madrigal Pharmaceuticals. In this foundational session, Jessica breaks down the new 2023 steatotic liver disease nomenclature, replacing NAFLD and NASH with MASLD and MASH, and explains how these changes align with updated AASLD guidelines. Through a case-based approach, she walks through key diagnostic criteria, highlighting the role of cardiometabolic risk factors, non-invasive assessments such as FIB-4, FibroScan, and ELF, and when to consider liver biopsy for staging fibrosis. Learn how to stratify patients based on metabolic profiles, evaluate imaging and lab results, and identify those at risk for progression to advanced fibrosis or cirrhosis. Jessica also discusses global epidemiology, genetics (like PNPLA3), environmental contributors, and the clinical importance of early detection. With a comprehensive workup strategy for primary care and GI settings, this session equips providers to implement guideline-driven MASLD evaluation and referral practices for improved patient outcomes.
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MASLD Basics With Ellie Gonyeau
August 2025
Join Ellie Gonyeau, NP, a GI and hepatology nurse practitioner at Beth Israel Deaconess Medical Center in Boston, for a foundational overview of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), formerly known as NAFLD. Presented through the GHAPP MASLD Community Network and sponsored by Madrigal Pharmaceuticals, this session covers the latest updates in MASLD nomenclature, diagnostic criteria, and non-invasive evaluation strategies. Ellie walks through the 2023 guidelines, emphasizing how MASLD is defined by hepatic steatosis in the presence of at least one metabolic risk factor—such as obesity, type 2 diabetes, hypertension, or dyslipidemia—and the importance of ruling out excessive alcohol use and other causes of chronic liver disease. Using real-world case examples like "JP", Ellie illustrates how to assess disease severity using tools such as FIB-4, FibroScan, and lab workups, while explaining when to consider specialty referral, further imaging, or liver biopsy. The talk also highlights the alarming rates of MASLD in high-risk populations, such as the Latin American community, and explores the disease's potential to silently progress to MASH, fibrosis, or cirrhosis. Whether you're in primary care, GI, or hepatology, this session provides critical insights on early detection, risk stratification, and guideline-based management of this increasingly prevalent condition.
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Non-Invasive Testing With Brian Lam
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.
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Lifestyle Management With Allysa Saggese
August 2025
Join Allysa Saggese, NP, from Weill Cornell Medicine in New York City, for an insightful and practical discussion on lifestyle management for MASLD and MASH, presented through the GHAPP MASLD/MASH Community Network, sponsored by Madrigal Pharmaceuticals. In this case-based presentation, Allysa walks viewers through the non-pharmacologic strategies used to manage Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), highlighting the role of nutrition, physical activity, and patient-centered counseling. Using a real-world example of a 65-year-old patient with obesity, diabetes, and steatosis, Allysa demonstrates how to assess fibrosis risk through non-invasive testing like FIB-4 and FibroScan, and explains how lifestyle modifications remain central to slowing disease progression—even in the era of advanced therapeutics. The session explores the importance of motivational interviewing, cultural dietary preferences, and how to structure effective, individualized conversations around reducing sugar intake, increasing movement at home, and achieving sustainable 5–10% weight loss to improve liver histology. Allysa also breaks down the metabolic interplay between central adiposity, insulin resistance, and liver inflammation, and shares counseling tips to build patient trust and long-term engagement. Whether you're a GI or hepatology provider, this session delivers real-world guidance to help empower patients to reverse early liver damage through everyday lifestyle changes.
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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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Non-Invasive Testing With Kelly Smeester
August 2025
Join Kelly Smeester, MMS, RD, PA-C, from South Denver Gastroenterology, for an in-depth discussion on the latest tools and strategies in non-invasive liver disease assessment, presented through the GHAPP MASLD Community Network. This evidence-based session walks viewers through a case study of a patient with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and explores the full range of non-invasive testing modalities used to evaluate liver fat, stiffness, and fibrosis risk. Kelly breaks down the utility of key tests including FIB-4, ELF Score, FibroScan (VCTE), and MR Elastography, and compares their accuracy, accessibility, limitations, and clinical value. Learn how to interpret biomarkers such as CAP (Controlled Attenuation Parameter) and kPa (Kilopascals), how to navigate indeterminate FIB-4 results, and when to escalate to more advanced imaging like MRE. The session also provides insights into combined scoring models (FAST, MAST, MEFIB), real-world use cases, and how comorbidities and patient-specific factors (BMI, ALT, bilirubin, ascites) can impact test reliability. Whether you're managing early-stage fatty liver disease or advanced fibrosis, this session provides essential knowledge to guide accurate diagnosis, risk stratification, and long-term monitoring without a liver biopsy.
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MASLD Pharmacotherapy With Lisa Richards
August 2025
Join Lisa Richards, NP, from UC San Diego Health, for a comprehensive overview of MASLD Pharmacotherapy as part of the GHAPP MASLD Community Network, proudly sponsored by Madrigal Pharmaceuticals. This educational session explores the evolving treatment landscape for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH (Metabolic Dysfunction-Associated Steatohepatitis), including the shift from exclusive reliance on lifestyle interventions and comorbidity optimization to the introduction of targeted pharmacologic therapies. Lisa reviews the role of GLP-1 receptor agonists, such as semaglutide, and the ESSENCE trial results demonstrating significant improvements in MASH and liver fibrosis. She also outlines the clinical considerations and limitations of legacy treatments like vitamin E and pioglitazone, based on data from the PIVENS trial. The highlight of the session is a detailed exploration of resmetirom (Rezdiffra)—the first FDA-approved therapy for non-cirrhotic NASH with moderate to advanced fibrosis (F2–F3). Lisa reviews key findings from the MAESTRO-NASH trial, including improvements in fibrosis and MASH resolution, and discusses real-world implementation strategies, including non-invasive monitoring tools (FibroScan, ELF, MRI-PDFF), statin dose adjustments, and managing drug–drug interactions. This session equips hepatology and GI providers with the tools to personalize MASH care, navigate insurance and safety considerations, and deliver cutting-edge, evidence-based treatment to patients with MASLD.
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MASLD Pharmacotherapy With April Morris
August 2025
Join April Morris, FNP, a hepatology and endocrinology nurse practitioner, for a comprehensive review of MASLD pharmacotherapy as part of the GHAPP MASLD Community Network. This expert-led session outlines a three-pronged strategy for managing Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH, focusing on obesity reduction, cardiometabolic risk control, and liver-directed treatment. April walks through first-line lifestyle approaches, highlights key pharmacologic agents like GLP-1 receptor agonists, and explains their mechanisms and clinical relevance—including the groundbreaking data from the semaglutide trials showing resolution of MASH and improvement in liver fibrosis. The session also reviews the role and limitations of vitamin E and pioglitazone, emphasizing their risks in patients with diabetes or cardiovascular disease. The spotlight then shifts to resmetirom (Rezdiffra), a thyroid hormone receptor beta agonist FDA-approved for adults with non-cirrhotic NASH and moderate-to-advanced fibrosis (F2–F3). April explains the MAESTRO-NASH trial endpoints, clinical efficacy, common side effects, and appropriate patient selection. Learn how resmetirom improves fatty acid oxidation, reduces hepatic fat and fibrosis, and the key drug–drug interactions and statin dose considerations to manage during treatment. The discussion concludes with practical tips for monitoring, non-invasive staging (FibroScan, ELF, MRI-PDFF), and the evolving guidance on treatment duration, safety labs, and insurance barriers. This session is essential for clinicians navigating the growing landscape of therapeutic options in MASLD/MASH care.
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Comparing F3 and F4 Fibrosis With Alison Moe
August 2025
Join Alison Moe, PA-C, from Atlanta Gastroenterology Associates, for a case-based, practical exploration of how to identify, risk stratify, and manage patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH (Metabolic Dysfunction-Associated Steatohepatitis). In this engaging session from the GHAPP MASLD Community Network, Alison walks through the clinical implications of differentiating F3 fibrosis from F4 cirrhosis, highlighting the importance of non-invasive testing tools such as FIB-4, FibroScan (KPA scores), CAP scores, and ELF tests in determining appropriate treatment pathways. Learn how platelet counts, ALT/AST levels, and liver stiffness scores play a critical role in determining whether a patient qualifies for medical therapy like resmetirom (Rezdiffra), or instead requires HCC surveillance and screening for portal hypertension. The session also reviews how to integrate GLP-1 receptor agonists for patients with concurrent type 2 diabetes and obesity, and why diet and lifestyle modifications remain foundational in all stages of care. Allison emphasizes FDA treatment criteria, shares decision-making strategies around ambiguous fibrosis scoring, and explains how to use real-world diagnostic markers to drive individualized liver care. This is an essential update for GI, hepatology, and primary care providers managing the growing population of MASLD/MASH patients.
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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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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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Comparing F3 and F4 Fibrosis With Christie Morrison
August 2025
In this expert-led session, Christie Morrison, NP, shares a comprehensive case-based discussion on comparing F3 vs F4 fibrosis in patients with MASH (Metabolic Dysfunction-Associated Steatohepatitis). Through the lens of two real-world clinical scenarios, Christie breaks down the nuanced differences in non-invasive diagnostic tools such as FIB-4, ELF scores, and FibroScan KPA readings, while guiding providers on how to stratify risk, monitor disease progression, and tailor interventions appropriately. Viewers will learn how elevated liver enzymes, declining platelet counts, and steatosis scores influence decision-making in patients with metabolic comorbidities like type 2 diabetes, hypertension, and hyperlipidemia. The session emphasizes evidence-based lifestyle and pharmacologic strategies, including the potential role of resmetirom (Rezdiffra) in F3 fibrosis and why it’s contraindicated in advanced cirrhosis. Learn when to initiate HCC surveillance, how to interpret borderline labs, and the importance of integrating GLP-1s, dietitian referrals, and cardiometabolic care to slow or reverse fibrosis progression. Whether you’re managing intermediate or advanced fibrosis, this educational session provides invaluable insights into optimal MASH care pathways and staging techniques.
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Lifestyle Management With Alison Moe
August 2025
Join Alison Moe, PA-C, from Atlanta Gastroenterology Associates, as she walks through a real-world clinical case highlighting the challenges and strategies in managing Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH). In this engaging and educational session, Alison shares the case of a 65-year-old Hispanic male with obesity, type 2 diabetes, and fatty liver disease—diving deep into non-invasive diagnostic tools, including FIB-4 scoring and FibroScan, and how these help guide risk stratification for liver fibrosis. The discussion emphasizes the crucial role of dietary counseling, culturally sensitive lifestyle modifications, and exercise guidance to slow or even reverse disease progression. Learn how to set achievable goals for patients and explore effective methods for improving glycemic control, BMI, and overall liver health. Alison also touches on evidence-based interventions such as the Mediterranean diet, resistance training, and intermittent fasting, supported by AASLD and European liver guidelines. Whether you're a clinician treating MASLD or simply interested in the evolving approach to fatty liver disease, this case study offers practical takeaways and guidance to optimize patient outcomes.
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MASLD Pharmacotherapy
July 2025
In this dynamic and highly informative session, Sherona Bau, NP, presents a comprehensive overview of pharmacotherapy in MASLD and MASH, breaking down current treatment strategies and emerging therapies for patients with metabolic dysfunction-associated steatotic liver disease. This presentation, part of the MASLD/MASH Community Network, begins by contextualizing the recent nomenclature shift from NAFLD/NASH to MASLD/MASH and its clinical implications. Sherona explores lifestyle intervention targets, including Mediterranean diet, weight loss goals based on fibrosis stage, and the role of GLP-1 and GIP receptor agonists in improving liver health. She highlights the ESSENCE trial results for semaglutide, discusses the only FDA-approved therapy to date—resmetirom (Rezdiffra)—and explains its mechanism of action via thyroid hormone receptor beta activation. The session dives deep into efficacy data from the MAESTRO-NASH trial, side effect profiles, drug–drug interactions, and monitoring recommendations. She also previews a pipeline of promising agents in phase 2 and 3 trials—including tirzepatide (GLP-1/GIP), cotadutide (GLP-1/GR), pemvidutide (GLP-1/GIP), and retatrutide (GLP-1/GIP/GR)—offering insight into what’s next in the evolving treatment landscape. This is a must-watch for hepatology and endocrinology clinicians focused on the future of fatty liver management.
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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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Comparing F3 and F4 Fibrosis With Edith Johannes
July 2025
Join Edith Johannes, NP from UCLA Health, for a comprehensive and approachable introduction to MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease)—formerly known as NAFLD—and how to accurately diagnose it. Designed for primary care providers and early learners in hepatology, this session outlines the fundamental criteria for diagnosing MASLD and MASH, the importance of ruling out alternate causes of hepatic steatosis, and the key role of cardio-metabolic risk factors. Edith discusses how to apply non-invasive testing tools such as the FIB-4 score, ELF test, and elastography to determine fibrosis stage, along with guidance on when to consider liver biopsy and refer to hepatology. The presentation also explores the overlap between MASLD and alcohol-related liver disease, addresses the impact of genetic risk factors like PNPLA3 (particularly in Hispanic populations), and reinforces the urgent need for early detection to prevent cirrhosis and liver cancer. With clinical pearls and case-based examples, this session helps clinicians feel confident in evaluating patients for MASLD and navigating next steps for care.
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Non-Invasive Testing With April Morris
July 2025
In this educational presentation, April Morris, FNP—an experienced provider in both liver disease and endocrinology—guides viewers through the evolving landscape of non-invasive testing (NITs) for diagnosing and managing patients with MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH. Using the case of a 65-year-old male with metabolic co-morbidities and suspected liver disease, Morris reviews how to effectively apply tools like the FIB-4 score, ELF test, and FibroScan (VCTE) to assess fibrosis risk and stratify patients. She compares imaging modalities including transient elastography, MR elastography (MRE), and shear wave elastography, offering practical considerations such as patient eligibility, test accuracy, and insurance barriers. The discussion emphasizes the importance of interpreting NITs within clinical context—highlighting how to determine risk, guide patient counseling, and establish a follow-up plan for low-risk patients. This session also reinforces the role of primary care in longitudinal liver health management and directs providers to resources available through the GHAPP MASLD & MASH Community Network.
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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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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 Sherona Bau
July 2025
In this engaging and highly informative GHAPP MASLD Community Network session, Sherona Bau, PA-C, walks attendees through a practical overview of non-invasive testing (NIT) for evaluating liver health in patients with MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). Drawing on real-world clinical experience, Sherona explains why non-invasive testing is essential for identifying fibrosis risk in a population where liver steatosis is prevalent in up to 30% of U.S. adults. Through the case of a 65-year-old Hispanic male named Albert, Sherona demonstrates how to interpret and apply tools such as FIB-4, FibroScan (VCTE and CAP score), ELF (Enhanced Liver Fibrosis) test, and MR Elastography (MRE). She highlights their respective strengths, limitations, clinical cut-offs, and insurance-related considerations. The session also covers when to order tests, how to assess data quality (e.g., IQR/median ratio in VCTE), and when to escalate care to hepatology or cardiology. Whether you are a primary care provider, endocrinologist, or hepatology specialist, this talk delivers practical algorithms and decision-making pathways for managing MASLD, improving early detection of fibrosis and cirrhosis, and integrating cardiovascular risk assessment into liver care. Sherona also emphasizes the importance of alcohol use history, metabolic syndrome risk factors, and annual NIT follow-up in patients at risk for disease progression.
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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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Lifestyle Management With Erin Parkinson
July 2025
In this impactful session from the GHAPP MASLD Community Network, Erin Parkinson, NP, explores the vital role of lifestyle modifications in the management of MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). Through the lens of a real-world case study, Erin illustrates how clinical tools like FIB-4 and FibroScan® can be used to assess fibrosis risk and guide interventions for patients presenting with metabolic syndrome and hepatic steatosis. With a focus on practical, personalized care, this presentation highlights how diet, exercise, and culturally sensitive counseling can meaningfully reduce hepatic fat, inflammation, and fibrosis—key factors in preventing progression to cirrhosis or hepatocellular carcinoma. Erin discusses the impact of processed foods, high-fructose corn syrup, and sedentary behavior, while offering actionable guidance on introducing Mediterranean diets, intermittent fasting, and realistic exercise goals tailored to individual readiness and barriers. Whether you're a hepatology specialist, primary care provider, or obesity medicine clinician, this talk delivers tools to better support patients with MASLD/MASH through sustainable behavioral change and longitudinal follow-up.
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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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Comparing F3 and F4 Fibrosis With Lindsay Pratt
July 2025
Join Lindsey Pratt, PA-C from the University of Colorado Liver Transplant Program, for an in-depth clinical comparison of F3 and F4 fibrosis in patients with MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). Using an identical patient profile with differing non-invasive testing results, Lindsey demonstrates how to accurately stage fibrosis using tools like FIB-4, FibroScan, CAP score, and ELF test—emphasizing when pharmacologic intervention is appropriate and when advanced monitoring becomes critical. This session explores the clinical implications of fibrosis staging, treatment pathways including resmetirom (Rezdiffra), the role of GLP-1 receptor agonists, and practical nutrition and lifestyle strategies. For F4 patients, Lindsey outlines key elements of surveillance for hepatocellular carcinoma (HCC), portal hypertension management, and transplant evaluation. Whether you're in hepatology or primary care, this case-based discussion offers evidence-backed guidance for managing patients across the MASLD/MASH spectrum and preventing liver disease progression.
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Comparing F3 and F4 Fibrosis With Robin Soto
July 2025
In this in-depth case-based session from the GHAPP MASLD/MASH Community Network, Robin Soto, NP from UC San Diego Health, explores the clinical nuances of diagnosing and managing fibrosis stage 3 versus stage 4 in patients with MASH (Metabolic Dysfunction–Associated Steatohepatitis). Using a real-world case study of a patient named Sam, Robin demonstrates how to interpret and reconcile non-invasive tests (NITs) like FIB-4, FibroScan, CAP score, and ELF test to guide accurate staging. She offers practical insights into treatment decisions, including when to use resmetirom, the importance of lifestyle modification, and how to assess comorbidities like diabetes, obesity, and cardiovascular risk. The session also outlines when and how to monitor for hepatocellular carcinoma (HCC), implement liver cancer surveillance strategies, and approach multidisciplinary care for advanced fibrosis or cirrhosis. Whether you’re a hepatology specialist or a primary care provider, this video equips you with evidence-based tools for managing MASLD and optimizing outcomes in complex liver disease.
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Comparing F3 and F4 Fibrosis With Michelle Barnett
July 2025
In this installment of the GHAPP MASLD Community Network, Michelle Barnett, PA-C from Peak Gastroenterology in Colorado Springs, presents a deep dive into the clinical management of MASH—formerly known as NASH or non-alcoholic steatohepatitis. Through two comparative case studies, Michelle explores the nuances of diagnosing and managing patients with F3 and F4 fibrosis. Learn how to effectively use non-invasive diagnostic tools like FIB-4, FibroScan, and ELF testing, and gain valuable insights into stratifying fibrosis risk, monitoring hepatocellular carcinoma (HCC), and determining when resmetirom is appropriate. This session also covers practical guidance on nutrition, exercise, medication safety, and multidisciplinary care for patients with advanced liver disease. Whether you're a hepatology specialist or a primary care provider navigating the MASLD/MASH landscape, this video offers actionable strategies to improve long-term patient outcomes and reinforces the critical role of lifestyle intervention and liver disease surveillance.
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Lifestyle Management With Lisa Richards
July 2025
Join Lisa Richards, FNP-BC, from UC San Diego Health, as she leads a powerful educational session on the lifestyle management of MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) in this GHAPP MASLD/MASH Community Network event, sponsored by Madrigal Pharmaceuticals. Through a compelling clinical case study, Lisa walks viewers through a step-by-step approach to diagnosing MASLD, assessing fibrosis risk using noninvasive tools like FIB-4 and FibroScan, and implementing guideline-based interventions. Learn how to counsel patients on culturally sensitive dietary modifications, physical activity strategies, and behavior change techniques that improve outcomes. This session also explores the clinical relevance of weight loss thresholds, Mediterranean-style eating plans, and the importance of patient-centered goal setting. Whether you’re a provider managing metabolic liver disease or looking to integrate newer therapies like resmetirom, this video offers practical tools to empower sustainable change and improve liver health.
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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: Discordant NITs, the Gray Zone
June 2025
In this episode, Gabriella McCarty, NP at Northshore Gastroenterology in Cleveland, Ohio, shares her deep clinical insights on the evolving landscape of MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). With over 26 years of experience in private practice, Gabriella explains that the majority of fatty liver cases she encounters are found incidentally—often during evaluations for unrelated GI issues like GERD or routine colon screenings. She discusses the updated nomenclature from NAFLD to MASLD and outlines the cardiometabolic risk factors that inform diagnosis, such as obesity, diabetes, hypertension, and dyslipidemia. Gabriella emphasizes the importance of non-invasive assessments like FibroScan, FIB-4, ELF testing, and, in select cases, liver biopsy or MR elastography for accurate fibrosis staging. She also highlights the challenges of discordant test results and shares practical strategies for follow-up and monitoring. With a strong focus on lifestyle modification—promoting a Mediterranean diet, targeted weight loss, regular exercise, and alcohol avoidance—this episode provides essential education for providers managing patients with fatty liver disease, even when it's not the primary reason for the visit.
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Serological Workup: A Step-by-Step Guide
July 2025
In this comprehensive video, Sherona Bau, NP from UCLA, breaks down the essential hepatology workup for patients with MASLD (formerly NAFLD) and MASH, offering guidance for both primary care providers and GI/hepatology specialists. Drawing from her extensive clinical experience, she outlines a systematic approach to evaluating abnormal liver ultrasound findings—starting with critical labs to rule out chronic liver conditions like hepatitis B, hepatitis C, autoimmune hepatitis, PBC, and hereditary hemochromatosis. Sherona discusses the importance of ordering ANA, AMA, ferritin, serologies, and even specialized labs like the phosphatidylethanol (PEth) test to uncover alcohol-related liver disease that may be overlooked. She emphasizes the need to screen for cardiometabolic risk factors including type 2 diabetes and dyslipidemia and highlights non-invasive tests such as FibroScan and FIB-4 to help identify patients at risk of advanced fibrosis who may benefit from specialist referral. Most importantly, Sherona addresses the fears many patients face around liver disease progression and life expectancy, encouraging early intervention and coordinated care to improve long-term outcomes. This video is a must-watch for any clinician managing steatotic liver disease.
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Common Questions From Patients About MASH
July 2025
In this informative video, Ellie Gonyeau, a nurse practitioner in general gastroenterology at Beth Israel in Boston, answers some of the most common questions she hears from patients about MASLD (Metabolic dysfunction-Associated Steatotic Liver Disease). With compassion and clarity, Ellie addresses concerns about the seriousness of the condition, explaining that while MASLD can progress to advanced liver disease, early intervention can make a significant difference. She emphasizes the importance of not delaying care and encourages patients to take manageable steps—like losing just 5–10% of their body weight—to reduce liver inflammation and slow disease progression. Nutrition, exercise, and proactive conversations are central to her patient-centered approach. Whether you're newly diagnosed or seeking guidance, this episode offers valuable, practical insights for anyone navigating MASLD. #MASLD #FattyLiver #LiverHealth #GIcare #BethIsrael #NursePractitioner #Gastroenterology #PatientEducation #LiverDisease #WeightLossSupport
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MASH/MASLD in Type 2 Diabetes: Concurrent Medication Management
July 2025
In this informative episode, Whitney Steinmetz, NP from Presbyterian Medical Group in Albuquerque, NM, explores how to optimize medication strategies for patients with type 2 diabetes who are also living with MASLD and MASH. She discusses why individuals with type 2 diabetes are at significantly higher risk for developing advanced liver fibrosis—highlighting the overlapping metabolic, inflammatory, and insulin-resistant pathways that accelerate liver damage. Whitney breaks down how commonly prescribed diabetes medications—like GLP-1 receptor agonists, SGLT2 inhibitors, TZDs, and dual/triple incretins—impact liver fat, inflammation, and fibrosis progression. She offers practical guidance on selecting therapies that balance glycemic control with hepatic benefits while minimizing polypharmacy. Learn which medications may offer dual cardiometabolic and hepatic advantages, and which should be avoided or used with caution in patients with cirrhosis or advanced fibrosis. Tune in for real-world insights into how advanced practice providers can take ownership of MASH management in diabetes care.
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Common Questions from Patients About MASH
July 2025
In this impactful episode, Sherona Bau, NP from UCLA, addresses the most frequent and pressing questions patients ask after being diagnosed with MASLD (Metabolic dysfunction-associated steatotic liver disease) or MASH (Metabolic-associated steatohepatitis)—including concerns about life expectancy, risk of liver failure, liver cancer, and genetic impact on family members. She emphasizes the importance of risk stratification using non-invasive testing, particularly FibroScan®, to determine the extent of fat accumulation and liver fibrosis. Sherona explains that early identification of stage 2 or 3 fibrosis is critical, as treatment options are now available for these stages, offering hope for patients. She also stresses that MASLD is not just a liver disease—it's a systemic, metabolic condition—and encourages coordinated care with endocrinologists, cardiologists, and dietitians. Additionally, she discusses the hereditary nature of fatty liver and the importance of family screening, especially for children of affected individuals. This video offers clear, compassionate guidance for patients and providers navigating the complexities of fatty liver disease.
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Common Questions from Community GI About MASH
July 2025
In this practical and timely video, Erin Tanner, NP at Gastro Health in Birmingham, Alabama, shares expert insights on how community gastroenterology providers should approach incidental findings of fatty liver (MASLD/MASH) on abdominal imaging. With over 14 years of experience in GI and hepatology, Erin emphasizes that fatty liver can no longer be ignored, even when discovered during workups for unrelated GI symptoms like reflux or diarrhea. She walks through the step-by-step use of the FIB-4 index to risk-stratify patients and explains when to follow up with further non-invasive testing such as FibroScan® or ultrasound elastography. For patients with F3 fibrosis, Erin outlines next steps including lifestyle interventions, the use of Resmetirom, and the promise of GLP-1 therapies for future treatment. This is a must-watch for GI clinicians aiming to improve outcomes by proactively managing fatty liver disease in everyday practice.
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Common Questions from Primary Care Providers About MASH
July 2025
In this educational video, Erin Parkinson, ARNP-C at the Transplant Institute at Tampa General Medical Group, addresses two of the most frequently asked questions from primary care providers about MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). First, she explains when it’s appropriate to refer a patient to GI or hepatology, emphasizing the use of FIB-4 for risk stratification and recommending referral when scores are indeterminate or high, especially if a FibroScan® result shows ≥8 kPa. Erin also discusses lifestyle interventions, reinforcing the importance of weight loss and dietary modification, with strong endorsement of the Mediterranean diet—a recommendation supported by major liver societies. She also notes that intermittent fasting may be a helpful adjunct for patients seeking to improve liver health through sustainable weight reduction. This video provides practical tools for frontline providers to improve early detection and management of fatty liver disease.
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Common Questions from Primary Care Providers About MASH
July 2025
In this informative episode, Emily Przybyl, PA-C at Erie County Medical Center in Buffalo, NY, answers two of the most common questions primary care providers have about MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis): When should I refer to hepatology? and Is it safe to prescribe statins in patients with fatty liver disease? Emily explains that any history of hepatic steatosis on imaging or elevated liver enzymes (LFTs) is reason enough to initiate referral for further workup, including non-invasive testing like FIB-4 or FibroScan®. She also debunks the common myth that statins should be avoided in this population, emphasizing that statins are not contraindicated and are critical for managing cardiometabolic risk factors that drive liver disease progression. This episode is a must-watch for clinicians navigating MASLD/MASH in primary care, with practical guidance that supports early intervention and evidence-based management.
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Misconceptions About Liver Health
July 2025
In this quick but powerful video, Jeremy Davis, NP from Shreveport, Louisiana, addresses some of the most common misconceptions about liver health that he encounters in clinical practice. Many patients believe that liver disease only occurs in people who drink alcohol, but Jeremy explains how conditions like MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis) can affect individuals regardless of alcohol use. He also clears up the myth that only overweight patients are at risk, pointing out that co-morbidities such as hypertension, high cholesterol, cardiovascular disease, and type 2 diabetes can contribute to liver disease—even in patients with a normal BMI. Finally, Jeremy explains why normal liver enzyme labs (ALT and AST) don’t always rule out liver disease, making it crucial to assess underlying risk factors and improve provider and patient awareness. This video is a valuable resource for both healthcare professionals and patients looking to better understand non-alcoholic liver disease and why early screening matters.
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Common Questions from Patients About MASH
July 2025
In this focused episode, Suzanne Robertazzi, NP at the Washington DC VA, shares expert insights on how to prevent recurrence of MASH (Metabolic-associated steatohepatitis) and MASLD (Metabolic dysfunction-associated steatotic liver disease) in liver transplant recipients. Drawing on her experience caring for post-transplant veterans, Suzanne explains that MASH can return even after liver transplantation, making ongoing metabolic management essential. She outlines key strategies including tight blood sugar and blood pressure control, especially since transplant medications can contribute to hypertension. Suzanne also emphasizes the importance of introducing regular physical activity post-recovery and adopting a Mediterranean-style diet—while tailoring nutrition guidance to meet the needs of patients in urban settings with limited access to fresh foods. This video is a must-watch for transplant teams, hepatology providers, and patients seeking to extend the life and health of their new liver through evidence-based lifestyle and clinical interventions.
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Common Questions from Community GI About MASH
July 2025
In this insightful video, Christie Morrison, a local advanced practice provider with the GHAPP MASLD/MASH Community Network, answers two of the most frequently asked questions from community GI providers: when to refer patients with MASH to a transplant center and how to evaluate liver fibrosis when FibroScan® isn’t accessible. Christy emphasizes the importance of using non-invasive testing (NITs)—including FIB-4 and ELF (Enhanced Liver Fibrosis) scores—to help identify patients with F3 fibrosis, who are at higher risk for rapid progression to cirrhosis and hepatocellular carcinoma (HCC). She encourages early referral to transplant hepatology to avoid delays in care, especially given long wait times and the value of multidisciplinary support teams at transplant centers. For clinicians without access to FibroScan, Christy shares practical alternatives such as ordering reflex testing to ELF via major labs and leveraging easy-to-use digital tools like MDCalc for FIB-4 calculation. This episode is a valuable resource for GI providers looking to optimize liver care pathways and prevent late-stage complications in MASLD and MASH patients.
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Common Questions from Primary Care Providers About MASH
July 2025
In this educational video, Robin Soto, RN, MSN, FNP-BC from UC San Diego Health, answers common questions from primary care providers about the progression and management of MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). She addresses the often-misunderstood reality that fatty liver disease can progress to cirrhosis, even in patients with no history of alcohol use—challenging the stigma that surrounds liver disease. Robin explains how MASH is a progressive condition, and if left unmanaged, can lead to advanced fibrosis and liver failure. She also shares practical dietary advice for patients, highlighting the benefits of the Mediterranean diet—rich in healthy fats, fiber, and low in processed foods and sugars—as recommended by hepatology societies like AASLD. Importantly, she emphasizes that even modest weight loss (3–10%) can significantly improve steatosis, inflammation, and even reverse fibrosis. This video is a valuable resource for clinicians and patients alike, focused on prevention, early intervention, and empowering lifestyle changes.
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Common Questions From Primary Care Providers About MASH
July 2025
In this insightful episode, Jessica Crimaldi, NP from the Cleveland Clinic, addresses two of the most frequently asked questions from primary care providers about MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). First, she clarifies a common concern regarding statin use in patients with liver disease, emphasizing that statins are not only safe in most cases—including compensated cirrhosis—but also beneficial in managing cardiometabolic risk factors and slowing disease progression. She explains when statins are contraindicated and encourages collaboration with hepatology if there are concerns. Second, Jessica outlines a practical pre-referral workup for suspected MASLD/MASH patients. She details the labs needed to calculate FIB-4, suggests ordering an INR, and highlights the importance of screening for viral hepatitis, autoimmune liver disease, and common genetic liver disorders. This episode offers clear, actionable guidance for providers managing fatty liver disease in primary care and is a valuable resource for improving early diagnosis and coordinated care.
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Common Questions From Community GI About MASH
July 2025
In this session, Lavinia Iordache, PA-C, from the University of Miami, draws on a decade of experience in inpatient and outpatient hepatology to address common management questions related to MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). She provides practical guidance for gastroenterology providers navigating when to monitor versus refer patients with fibrosis, how to interpret and time non-invasive testing (NITs) such as FIB-4, and when liver biopsy may still play a role—particularly in cases with persistently elevated liver enzymes despite lifestyle improvement. Lavinia also dives into the referral criteria for hepatology, the evolving role of resmetirom in stage 2–3 fibrosis, and the critical topic of HCC screening. While current AASLD guidelines limit HCC surveillance to cirrhosis, Lavinia highlights emerging evidence and EASL recommendations supporting imaging in patients with F3 fibrosis based on individualized risk factors like diabetes, genetics, and obesity. She also explains why CT or MRI is often preferred over ultrasound in MASLD patients due to obesity-related imaging limitations. This is a must-watch for hepatology and GI teams managing liver fibrosis in metabolic disease.
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Misconceptions About Liver Health
July 2025
In this short and informative video, Miu Lai Ng, a nurse practitioner at Tufts Medical Center, debunks two of the most common myths about liver health. First, she sets the record straight on liver cleanses and detox teas—explaining that your liver already detoxifies your body daily and doesn’t need fad diets or trendy supplements. Instead, what your liver needs is support through sustainable habits like reducing alcohol intake, cutting back on processed sugars, and maintaining a healthy weight. She also highlights a critical point: liver disease is often silent, and many people with significant liver damage have no symptoms until it’s advanced. If you're at risk due to metabolic syndrome, alcohol use, or other factors, Miu Lai urges you to talk to your healthcare provider about screening options like FIB-4 or FibroScan®. Your liver works hard for you—this video is a reminder to return the favor with real, lasting care.
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Misconceptions About Liver Health
July 2025
In this quick myth-busting session, Elizabeth Alqueza, PA-C from Beth Israel Deaconess Medical Center in Boston, addresses two of the most common misconceptions in hepatology related to steatotic liver disease (MASLD/MASH). First, she explains that liver disease is not always fixed or irreversible—and with proper management and elimination of the underlying cause, liver fibrosis can improve over time, a trend often monitored through FibroScan®. Second, she clarifies that significant liver improvement does not require extreme weight loss. In fact, a modest 5–10% reduction in total body weight—sometimes as little as 10–20 pounds—can lead to measurable improvements in liver inflammation and fibrosis. This video is ideal for providers and patients seeking a clearer understanding of how lifestyle changes can reverse liver disease and why timely, targeted interventions matter.
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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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Non-Invasive Testing With Jordan Mayberry
July 2025
In this educational session, Jordan Mayberry, PA-C from UT Southwestern, presents a practical overview of non-invasive testing for diagnosing and staging metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic-associated steatohepatitis (MASH). Using a real-world patient case, Jordan discusses how clinicians can leverage key tools—such as FIB-4, ELF testing, FibroScan (VCTE), and MRI elastography—to assess fibrosis and stratify risk in patients with MASLD. She explains the benefits, limitations, and clinical applications of each modality, including guidance on when and how to use them in everyday practice. Whether you're a hepatology specialist or a provider managing patients with cardiometabolic risk factors, this talk delivers a clear, step-by-step approach to incorporating non-invasive liver assessment into your workflow. Viewers are also invited to explore the GHAPP MASLD/MASH Community Network for ongoing education, resources, and clinical insights.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Gabriella McCarty, NP-C, of Northshore Gastroenterology in Cleveland, Ohio, tackles common misconceptions surrounding fatty liver disease, also known as MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease). Drawing from her clinical experience, Gabriella highlights how fatty liver is often an incidental finding during routine GI visits, even when patients present for unrelated concerns like GERD or colon screenings. She emphasizes that MASLD is not caused by alcohol, but instead driven by metabolic risk factors such as obesity, diabetes, high cholesterol, and hypertension. Gabriella dispels the myth that normal liver enzymes indicate a healthy liver, explaining that liver markers are often unreliable in detecting advanced fibrosis or cirrhosis. She also warns against unregulated liver detox products and the outdated belief that fatty liver is harmless. With MASLD now the most common liver disease worldwide and increasing rates among younger populations, Gabriella stresses the importance of early screening, lifestyle modification, and patient education. This is a must-watch for anyone looking to better understand the silent progression of fatty liver disease and the tools available for timely intervention.
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Common Questions From Patients About MASH
July 2025
In this practical and patient-focused discussion from the GHAPP MASLD/MASH Community Network, we address some of the most frequently asked questions by patients newly diagnosed with MASLD (Metabolic dysfunction-associated steatotic liver disease). Many patients wonder how they can have liver disease if they don’t drink alcohol. This video explains the evolution from NAFLD to MASLD, emphasizing that MASLD is rooted in metabolic risk factors—not alcohol use—and commonly affects individuals with diabetes, obesity, and hypertension. Viewers will also learn about evidence-based lifestyle interventions, including the benefits of a hypocaloric diet, the recommended Mediterranean-style eating pattern, and 150 minutes of weekly physical activity. Finally, we tackle the question “Is MASLD curable?” with empowering guidance on how weight loss and exercise can help reverse liver damage and reduce liver fat. This is a must-watch for clinicians, care teams, and patients seeking clarity and confidence in managing this increasingly common liver disease.
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Common Questions From Primary Care Providers About MASH
July 2025
In this informative session, Jennifer Geremia, PA-C, a seasoned gastroenterology physician assistant in tertiary care Boston, addresses some of the most common questions primary care providers have about identifying and managing patients with fatty liver disease, MASLD (Metabolic dysfunction-associated steatotic liver disease), and MASH (Metabolic-associated steatohepatitis). Jennifer highlights the importance of using FIB-4 as a first-line non-invasive test (NIT) in high-risk patients with diabetes, obesity, or other metabolic conditions—noting how easily this tool can be integrated into routine labs via the EMR. She underscores that the liver is often overlooked in chronic disease management and makes a strong case for routine fibrosis screening alongside cardiovascular and diabetes evaluations. The talk also dives into actionable next steps after FIB-4 testing, including elastography, ELF testing, and referrals to GI when needed. Jennifer closes by discussing realistic lifestyle intervention goals—especially the importance of 7–10% weight loss for meaningful reductions in steatosis and fibrosis risk. This session is a must-watch for PCPs, APPs, and clinicians managing metabolic comorbidities and seeking practical, evidence-based strategies for early MASH detection and management.
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Common Questions From Primary Care Providers About MASH
July 2025
In this concise and practical discussion, Lindsay Pratt, PA-C from the University of Colorado’s Department of Hepatology and Liver Transplant, shares expert guidance on screening and managing patients with MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). Speaking directly to the common questions she receives from primary care providers, Lindsay outlines when to screen for MASLD/MASH—emphasizing the importance of evaluating patients with elevated liver enzymes, hepatic steatosis on imaging, and cardiometabolic risk factors like diabetes, hypertension, hyperlipidemia, and sleep apnea. She breaks down the utility of FIB-4 as a first-line non-invasive test, when to use FibroScan®, and clears up a common misconception about statin use in liver disease—encouraging providers to continue or initiate statins when indicated. This session is ideal for clinicians managing metabolic syndrome and its liver manifestations and offers simple, evidence-based tools to identify at-risk patients early.
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APP Insight: Common Questions from Patients About MASH
June 2025
In this episode, Jordan Mayberry, MPAS, PA-C, a seasoned hepatology provider at UT Southwestern in Dallas, Texas, addresses some of the most frequently asked questions from patients diagnosed with MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). With over 12 years of clinical experience, Jordan explains the root causes of MASLD/MASH, including key cardiometabolic risk factors like obesity, diabetes, hypertension, and hyperlipidemia, as well as genetic predispositions—particularly in Hispanic populations. He emphasizes the importance of fibrosis assessment in guiding treatment decisions, explaining that patients with early-stage disease should focus on lifestyle changes, while those with more advanced fibrosis (stages F2–F3) may be candidates for pharmacologic therapy such as resmetirom (Rezdiffra). Jordan also explores how prognosis depends on fibrosis stage and long-term management of comorbidities, making early intervention and risk stratification essential. This episode offers practical insights for clinicians aiming to improve conversations and care strategies for patients living with MASLD or MASH.
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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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NITs: A Practical Overview: Navigating the Basics
July 2025
In this practical and engaging overview, Janet Gripshover, nurse practitioner and nurse manager for the Cedars-Sinai Liver Transplant Program, breaks down the essentials of non-invasive testing (NITs) for assessing fibrosis in patients with metabolic-associated steatotic liver disease (MASLD). She explains the critical distinction between MASLD and MASH (metabolic-associated steatohepatitis), highlighting why early identification of aggressive liver disease is essential—even in patients without cirrhosis. Janet reviews key NIT tools, including FibroScan, MR elastography, and serum biomarkers like FIB-4 and ELF score, providing clinical insights on interpreting results, integrating them into risk stratification, and tailoring next steps for patient care. Viewers will learn when to act on elevated liver stiffness, how to interpret CAP scores, and why weight loss and comorbidity control remain foundational treatments. Whether you're new to hepatology or seeking a refresher on navigating fibrosis assessments, this video offers a clear, actionable framework to help prevent disease progression and optimize outcomes for patients with fatty liver disease.
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Non-Invasive Testing With Janet Gripshover
July 2025
In this in-depth and practical discussion, Janet Gripshover, NP from Cedars-Sinai in Los Angeles, explores the evolving role of non-invasive testing (NITs) in the diagnosis and risk stratification of MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). Drawing from real-world experience and a case study involving a 65-year-old patient with multiple cardiometabolic risk factors, she breaks down the latest 2025 approaches to fibrosis assessment—highlighting the use of FIB-4, ELF score, vibration-controlled transient elastography (FibroScan®), and MR elastography. Gryover also emphasizes how combining tests across modalities can improve accuracy and patient care while avoiding the risks of liver biopsy. Learn how liver stiffness, lab values, and clinical history all intersect to guide care and treatment decisions in patients with fatty liver disease. This session is part of the MASLD/MASH Community Network and is ideal for providers, specialists, and anyone interested in the forefront of liver disease management.
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APP Insight: Common Questions from Community GI About MASH
June 2025
In this informative video, Janet Gripshover, DNP, FNP-BC, and nurse manager for the liver transplant program at Cedars-Sinai, answers key questions about managing MASH (Metabolic Dysfunction–Associated Steatohepatitis) and navigating non-invasive testing. She addresses a common clinical challenge—what to do when FIB-4 and FibroScan results are discordant. Janet explains that while non-invasive tests are useful, they're not foolproof, and when results are unclear—especially in patients with significant metabolic risk factors—liver biopsy remains the gold standard for accurate diagnosis. She also shares expert recommendations on dietary changes for patients with fatty liver disease, emphasizing alcohol avoidance, high-protein, low-fat, and lower-carb diets, as well as achievable weight loss goals (around 5% of body weight). Janet highlights when to escalate care beyond lifestyle interventions—typically after 3 to 6 months if there’s no improvement—and discusses options such as pharmacologic therapy or bariatric surgery. This video provides practical, evidence-based guidance for healthcare providers managing the complexities of MASLD and MASH.
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GHAPPcast: Recognizing the Severity of MASH
January 2025
Thank you to Madrigal for sponsoring this episode of GHAPPcast. In this episode of GHAPPcast, nurse practitioners Patrick Horne and April Morris from discuss the complexities of identifying and managing patients with metabolic-associated steatohepatitis (MASH). They explore clinical approaches, including the use of bloodwork, family history, and advanced diagnostic tools such as FibroScan, to recognize patients at risk. Patrick and April emphasize the importance of lifestyle interventions like diet and exercise alongside new medical therapies, while also offering practical tips for clinicians on patient monitoring and treatment management. Tune in for valuable insights into managing MASH in clinical practice.
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Alcohol and MASLD/MASH: Navigating the Complex Relationship
July 2025
In this insightful episode, Oyin Penny, NP with Premier Gastroenterology of Kansas City, addresses the complex clinical challenge of managing patients with MASLD (metabolic dysfunction-associated steatotic liver disease) who also consume alcohol. Oyin shares practical, evidence-based strategies for screening alcohol use in MASLD and MASH, emphasizing the importance of creating a nonjudgmental, patient-centered environment. She outlines how to use tools like PEth (phosphatidylethanol) testing to objectively quantify alcohol intake and explains the synergistic hepatotoxicity that occurs when alcohol use coexists with metabolic liver disease. Oyin also explores when to initiate non-invasive tests (NITs), why alcohol can distort fibrosis staging, and how to time assessments and treatment appropriately. From setting SMART goals to recommending behavioral support, medications like naltrexone, and exploring mental health and social work interventions, this episode offers a full-spectrum approach to managing high-risk patients. Whether you're a GI, hepatology provider, or in primary care, this episode provides tools for personalized care, alcohol harm reduction, and effective long-term MASLD management.
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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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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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Monitoring for MASLD in Type 2 Diabetes
July 2025
In this episode, Kelly Smeester, PA-C from South Denver Gastroenterology, explores the critical intersection of type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD). Drawing from her background in both hepatology and endocrinology, Kelly offers practical, evidence-based strategies for non-invasive monitoring of liver fibrosis in patients with diabetes who may initially appear low risk. She highlights the utility of tools like FIB-4, ELF score, FibroScan, and MR elastography, while emphasizing the limitations of relying solely on liver function tests (LFTs). Kelly recommends annual FIB-4 screening—easily calculated with existing lab values—and discusses when to escalate to more advanced diagnostics. She also shares how advanced practice providers (APPs) can seamlessly integrate MASH education, lifestyle counseling, and routine screening into the diabetes care workflow, supporting early intervention and long-term liver health. This episode is a must-listen for clinicians looking to optimize care for patients at risk of silent liver disease progression in the setting of metabolic co-morbidities.
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Lifestyle Management With Christina Hanson
July 2025
Join Christina Hanson, NP from South Denver GI, for a practical and in-depth discussion on lifestyle management of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Steatohepatitis). In this GHAPP MASLD/MASH Community Network session, Christina walks through the case of Albert, a 65-year-old patient with obesity, diabetes, and abnormal liver findings—representing a common clinical scenario in primary and specialty care. This session highlights how to apply non-invasive fibrosis assessment tools like FIB-4 and FibroScan, interpret metabolic risk factors, and differentiate patients based on fibrosis staging. Christina discusses how cultural dietary habits, access to care, and social determinants of health impact disease management, and emphasizes the importance of personalized counseling, accountability strategies, and gradual, sustainable changes to diet and exercise. The session also reviews the role of Resmetirom, the first FDA-approved treatment for MASH with F2-F3 fibrosis, and outlines guideline-recommended lifestyle interventions including the Mediterranean diet and combined aerobic/resistance exercise. Learn how to identify, stage, and manage patients with MASLD and MASH in a way that supports long-term adherence and improves liver-related outcomes. Educational support provided by Madrigal Pharmaceuticals.
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Diet and Nutrition: Tailoring Plans for Diverse Populations
July 2025
In this quick and practical video, Miu Lai Ng, a nurse practitioner at the hepatology clinic at Tufts Medical Center in Boston, shares simple, culturally sensitive, and cost-effective dietary tips to help patients manage fatty liver disease—also known as MASH (metabolic dysfunction–associated steatohepatitis). From avoiding white-colored refined carbs like sugar, white rice, and potatoes to smart swaps like oatmeal—rich in soluble fiber and low on the glycemic index—this video emphasizes realistic changes tailored to diverse backgrounds. Miu Lai Ng also covers powerful tools for sticking with a liver-friendly diet, including food tracking apps, photo logging, meal planning tools, and the importance of social support. Plus, she highlights the hidden dangers of liquid calories found in sodas, juices, and bubble tea, which spike liver fat and cost more than you think. Whether you're supporting a patient or managing MASH yourself, this video offers actionable advice that respects both culture and budget—because small changes can lead to big results for your liver and your life.
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Podcast: LFTs Demystified: A Practical Guide for APPs
June 2025
In this podcast episode, Michelle Barnett, PA-C, a liver disease specialist based in Colorado Springs, provides a clear and practical overview on demystifying liver enzyme abnormalities—particularly in the context of MASH (Metabolic Dysfunction–Associated Steatohepatitis) and MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease). With MASLD affecting nearly 1 in 4 American adults, understanding liver enzyme patterns is critical for early detection and effective management. Michelle breaks down commonly reported values from hepatic function panels—ALT, ALP (alkaline phosphatase), and total bilirubin—explaining what constitutes normal, acute, subacute, and chronic elevations. She walks through hepatocellular, cholestatic, mixed, and isolated hyperbilirubinemia patterns and what they reveal about underlying liver conditions such as MASH, alcohol-associated liver disease, viral hepatitis, biliary obstruction, and drug-induced liver injury. Whether you're a provider or a patient looking to better understand lab results, this episode delivers expert guidance on interpreting liver enzyme elevations to support more informed clinical decisions.
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The Role of Exercise in Liver Health
July 2025
In this episode, Suzanne Robertazzi, DNP at the Washington DC VA Medical Center, discusses the vital role of exercise in liver health, especially for patients at risk of or living with MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH. With a background in liver transplant care, Suzanne emphasizes the importance of tailoring exercise recommendations to each patient’s abilities, goals, and environment. She outlines practical, empathetic strategies for setting realistic fitness goals, celebrating small milestones, and integrating physical activity with nutritional counseling and behavioral support. Whether it's walking, swimming, or group classes, Suzanne explores low-cost and community-based options for promoting long-term adherence. This episode also highlights the benefits of a multidisciplinary approach, including collaboration with physical therapists, mental health professionals, and dietitians. Packed with actionable insights, this conversation is essential for healthcare providers working to empower patients with fatty liver disease through sustainable lifestyle interventions.
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APP Insight: Common Questions from Patients About MASH
June 2025
In this insightful video, Patrick Horne, NP, from the University of Florida, addresses some of the most frequently asked questions from patients diagnosed with MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). Drawing from his clinical experience, he answers common concerns such as: “How did I get fatty liver if I don’t drink alcohol?”, clarifying that alcohol is not a necessary factor in developing these conditions—rather, metabolic risk factors like obesity, diabetes, hypertension, and genetic predisposition play a significant role. Patrick also dives into lifestyle recommendations, including the importance of adopting a mediterranean diet, engaging in regular physical activity, and setting realistic weight loss goals. Additionally, he tackles the nuanced question of alcohol consumption in patients with MASLD/MASH, emphasizing individualized care depending on the stage of liver disease. This session is a must-watch for both patients and providers seeking practical, evidence-based guidance on managing metabolic liver disease.
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MASLD Basics With Summer Collier
July 2025
Join Summer Collier, NP from UC San Diego Health, for an essential overview of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) in this GHAPP MASLD Community Network session. Designed for clinicians and healthcare professionals, this case-based talk covers the evolving nomenclature shift from NAFLD/NASH to MASLD/MASH, including key definitions, diagnostic criteria, and practical tools for identifying and managing patients with steatotic liver disease. Summer walks through foundational concepts like the role of hepatic steatosis, cardio-metabolic risk factors, and the importance of excluding significant alcohol use to establish a MASLD diagnosis. She also provides clinical insights into non-invasive fibrosis staging using FIB-4, FibroScan, elastography, and blood-based tests, as well as how to differentiate patients who may require hepatology referral or biopsy. Emphasizing the importance of early detection and risk stratification in primary care, this session highlights how fibrosis stage impacts prognosis, treatment planning, and long-term liver-related outcomes. For more educational sessions and MASLD tools — visit the GHAPP MASLD Community Network.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Christina Hanson, FNP-C, from South Denver Gastroenterology, dispels common myths around liver health and highlights a critical shift in how we identify and manage fatty liver disease. With the updated terminology from NAFLD/NASH to MASLD/MASH—Metabolic Dysfunction–Associated Steatotic Liver Disease—Christina explains how the new name more accurately reflects the underlying cardiometabolic drivers of the condition, such as obesity, type 2 diabetes, hypertension, and dyslipidemia. She emphasizes that liver enzyme abnormalities or incidental imaging findings should no longer be the only triggers for evaluation. Instead, clinicians—especially in primary care and endocrinology—should proactively screen high-risk patients using non-invasive tools like FIB-4 to assess for liver fibrosis. With over 50% of patients with type 2 diabetes and up to 90% of those with morbid obesity at risk for coexisting fatty liver, early identification and triage are vital to improving outcomes. This is a must-watch for healthcare providers seeking practical, guideline-driven strategies for detecting MASLD and MASH in everyday clinical practice.
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Monitoring for MASLD in Type 2 Diabetes
July 2025
In this episode of the GHAPP MASLD podcast series, Lavinia Iordache, PA-C from the University of Miami, shares expert guidance on monitoring metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes—a group at particularly high risk for disease progression. Lavinia explains the bidirectional relationship between MASLD and diabetes, highlighting the importance of early screening, timely non-invasive testing (NITs), and proactive management strategies to prevent advanced fibrosis and cirrhosis. She reviews essential tools such as FIB-4, ELF score, FibroScan, and MRI-PDFF, and offers clear recommendations on when to escalate care, refer to specialty clinics, or intensify follow-up. The discussion also covers the role of lifestyle interventions including the Mediterranean diet, intermittent fasting, exercise, and coffee consumption, as well as strategies to improve adherence despite psychosocial, cultural, or financial barriers. Lavinia emphasizes a multidisciplinary approach to managing MASLD and provides practical tips for tracking lifestyle changes, such as journaling and the use of the EDAS questionnaire. Whether you’re a GI, endocrinology, or primary care provider, this episode offers an actionable roadmap for reducing liver-related complications in patients with diabetes.
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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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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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NITs: A Practical Overview: Navigating the Basics
July 2025
Join Ellie Gonyeau, a nurse practitioner at Beth Israel in Boston, for an insightful podcast episode on metabolic dysfunction-associated steatotic liver disease (MASLD) and MASH, and how to effectively use non-invasive testing (NITs) to evaluate and manage patients with fatty liver disease. Ellie breaks down the differences between MASLD and MASH—explaining why distinguishing simple steatosis from inflammatory liver injury matters for long-term outcomes. She covers first-line serum-based tools like FIB-4 and ELF score, as well as imaging-based modalities including FibroScan and MR elastography, helping clinicians understand when and how to apply each test. With practical tips on interpreting fibrosis risk thresholds, stratifying patients with metabolic comorbidities, and educating primary care teams, this episode emphasizes the power of early identification, appropriate triage, and collaborative care to prevent disease progression. Whether you're working in general GI, primary care, or hepatology, this episode equips you with tools to make liver disease detection more proactive and patient-centered.
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NITs: A Practical Overview: Navigating the Basics
July 2025
In this episode, Christie Morrison breaks down the fundamentals of non-invasive testing (NITs) for evaluating patients with fatty liver disease, including MASLD and MASH. She explains the key differences between steatosis (MASLD) and steatohepatitis (MASH), highlighting how non-invasive tests can replace liver biopsy for staging fibrosis. Christy reviews common tools like FIB-4, NAFLD fibrosis score, Enhanced Liver Fibrosis (ELF) score, transient elastography (FibroScan), and MR elastography, and outlines how to choose the right test based on patient factors such as co-morbidities, geography, access to labs, and imaging availability. The episode also emphasizes the importance of fibrosis risk stratification, interpreting FIB-4 cutoffs, and monitoring liver stiffness or ELF scores after initiating lifestyle or pharmacologic treatment—including newer therapies like resmetirom. This is a must-watch for APPs, GI clinicians, and primary care providers seeking to improve care pathways and outcomes in patients with metabolic liver disease through practical, accessible strategies for fibrosis detection and management.
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MASH Bootcamp Q&A
March 2025
In this interactive Q&A session, a panel of liver disease experts discusses key challenges in diagnosing and treating metabolic dysfunction-associated steatohepatitis (MASH) using non-invasive testing and the latest therapeutic advancements. The panel explores the role of FibroScan, ELF scores, and cardiometabolic risk factors in diagnosing fibrosis, especially in patients with limited access to MRI or VCTE-based assessments. They also discuss how serologic testing can be a viable alternative in resource-limited settings and when a liver biopsy may not be necessary for diagnosis. The discussion highlights the FDA approval criteria for Resmetirom, its limitations in F4 patients, and practical strategies for determining treatment eligibility. The experts address real-world challenges, including diagnosing MASH in rural areas, evaluating confounding factors in fibrosis assessment, and ensuring comprehensive liver disease workups to rule out autoimmune conditions.
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