From Insight to Action: Tackling the MASLD and MASH Epidemic-Module 4: Evidence-Based Treatment of MASLD and MASH

Video Transcription

Video Summary

In this module on evidence-based treatment of metabolic dysfunction-associated steatohepatitis (MASH) and MASLD, Dr. Javier Morales outlines key therapeutic strategies and emerging advances. Current FDA-approved treatments for MASH include resmidiram (resmitteron), a selective thyroid hormone receptor beta agonist for patients with moderate to advanced fibrosis (F2-F3), and semaglutide, a GLP-1 receptor agonist approved for obese patients with MASH and type 2 diabetes. Both therapies demonstrate histologic improvements, fibrosis reduction, and metabolic benefits, though adverse events like gastrointestinal symptoms require management. Combination therapies involving pioglitazone, GLP-1 receptor agonists, and lifestyle modifications such as Mediterranean diet, weight loss (≥10%), and exercise are emphasized for optimizing outcomes. Monitoring includes biochemical markers (ALT), imaging (FibroScan, MRI-PDFF), and long-term clinical endpoints like liver-related events and cardiovascular outcomes. Guidelines from AASLD, ACE, EASL, and ADA vary but generally prefer pioglitazone and GLP-1 agonists in suitable patients. Emerging therapies under investigation include tirzepatide, cervatutide, and next-generation thyroid receptor agonists, with future potential for personalized medicine guided by biomarkers and AI. Comprehensive management addresses metabolic syndrome and comorbidities with an interdisciplinary approach focusing on early diagnosis, risk stratification, and tailored treatment strategies to prevent progression and improve quality of life in patients with MASLD/MASH.

Keywords

Metabolic dysfunction-associated steatohepatitis

MASH treatment

MASLD therapies

Resmidiram

Semaglutide

Combination therapy

Emerging therapies