EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD)

Journal of Hepatology, Journal Year: 2024, Volume and Issue: 81(3), P. 492 - 542

Published: June 7, 2024

Language: Английский

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The first MASH drug therapy on the horizon: Current perspectives of resmetirom

Liver International, Journal Year: 2024, Volume and Issue: 44(7), P. 1526 - 1536

Published: April 5, 2024

Abstract The rising prevalence of metabolic dysfunction‐associated steatotic liver disease (MASLD) poses a significant global health challenge, affecting over 30% adults worldwide. MASLD is linked to increased mortality rates and substantial healthcare costs, primarily driven by its progression steatohepatitis (MASH), which can lead severe complications including cirrhosis hepatocellular carcinoma. Despite growing burden, effective pharmacotherapy for MASLD/MASH has been lacking until the recent conditional approval resmetirom FDA. Resmetirom, liver‐targeted thyroid hormone receptor‐β selective drug, shown promise in clinical trials treating non‐cirrhotic MASH with moderate advanced fibrosis. It demonstrated efficacy reducing hepatic fat content, improving histology (both resolution fibrosis improvement), ameliorating biomarkers damage without effects on body weight or glucose metabolism. Notably, also exhibits favourable circulating lipids, potentially cardiovascular risk patients. safety profile appears acceptable, gastrointestinal adverse events being most common, though generally mild moderate. However, long‐term surveillance warranted monitor potential risks related thyroid, gonadal, bone diseases. Clinical implementation faces challenges patient selection monitoring treatment response, will heavily rely non‐invasive tests assessment. Nonetheless, represents landmark breakthrough treatment, paving way future therapeutic strategies aiming mitigate multifaceted associated this complex disease.

Language: Английский

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EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Obesity Facts, Journal Year: 2024, Volume and Issue: 17(4), P. 374 - 444

Published: Jan. 1, 2024

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty (NAFLD), is defined as (SLD) in the presence of one or more cardiometabolic risk factor(s) and absence harmful alcohol intake. The spectrum MASLD includes steatosis, metabolic steatohepatitis (MASH, NASH), fibrosis, cirrhosis MASH-related hepatocellular carcinoma (HCC). This joint EASL-EASD-EASO guideline provides an update on definitions, prevention, screening, diagnosis treatment for MASLD. Case-finding strategies with using non-invasive tests, should be applied individuals factors, abnormal enzymes, and/or radiological signs hepatic particularly type 2 diabetes (T2D) obesity additional factor(s). A stepwise approach blood-based scores (such FIB-4) and, sequentially, imaging techniques transient elastography) suitable to rule-out/in advanced which predictive liver-related outcomes. In adults MASLD, lifestyle modification - including weight loss, dietary changes, physical exercise discouraging consumption well optimal management comorbidities use incretin-based therapies (e.g. semaglutide, tirzepatide) T2D obesity, if indicated advised. Bariatric surgery also option obesity. If locally approved dependent label, non-cirrhotic MASH significant fibrosis (stage ≥2) considered a MASH-targeted resmetirom, demonstrated histological effectiveness acceptable safety tolerability profile. No pharmacotherapy can currently recommended cirrhotic stage. Management adaptations drugs, nutritional counselling, surveillance portal hypertension HCC, transplantation decompensated cirrhosis.

Language: Английский

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Natural history and progression of metabolic dysfunction-associated steatotic liver disease

˜The œLancet. Gastroenterology & hepatology, Journal Year: 2024, Volume and Issue: 9(10), P. 944 - 956

Published: Sept. 4, 2024

Language: Английский

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Steatotic liver disease

The Lancet, Journal Year: 2024, Volume and Issue: 404(10464), P. 1761 - 1778

Published: Nov. 1, 2024

Language: Английский

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Expert Panel Recommendations: Practical Clinical Applications for Initiating and Monitoring Resmetirom in Patients with MASH/NASH and Moderate to Noncirrhotic Advanced Fibrosis

Clinical Gastroenterology and Hepatology, Journal Year: 2024, Volume and Issue: 22(12), P. 2367 - 2377

Published: July 20, 2024

Metabolic dysfunction-associated steatotic liver disease affects 1 in 4 people the United States and western Europe, with an important proportion developing metabolic steatohepatitis (MASH), progressive subtype of disease. Cirrhosis caused by MASH is a leading indication for transplantation most common cause hepatocellular carcinoma. Hitherto, there have been no specific pharmacotherapies MASH. The recent conditional approval Food Drug Administration resmetirom treatment moderate or advanced presents much-anticipated therapeutic option patients noncirrhotic Specifically, intended population are fibrosis stages 2 3. also challenges, including how to noninvasively identify 2-3, exclude more who should not be treated until further data emerge on use this population. Herein we consider available literature regard identifying proposing criteria stopping treatment.

Language: Английский

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Long-term liver-related outcomes and liver stiffness progression of statin usage in steatotic liver disease

Gut, Journal Year: 2024, Volume and Issue: 73(11), P. 1883 - 1892

Published: Aug. 1, 2024

Background Statins have multiple benefits in patients with metabolic-associated steatotic liver disease (MASLD). Aim To explore the effects of statins on long-term risk all-cause mortality, liver-related clinical events (LREs) and stiffness progression MASLD. Methods This cohort study collected data MASLD undergoing at least two vibration-controlled transient elastography examinations 16 tertiary referral centres. Cox regression analysis was performed to examine association between statin usage mortality LREs stratified by compensated advanced chronic (cACLD): baseline measurement (LSM) ≥10 kPa. Liver defined as an LSM increase ≥20% for cACLD from <10 kPa or non-cACLD. reduction decrease cACLD. Results We followed up 7988 5.9 (IQR 4.6–8.2) a median 4.6 years. At baseline, 40.5% used statins, present 17%. Statin significantly associated lower (adjusted HR=0.233; 95% CI 0.127 0.426) HR=0.380; 0.268 0.539). also rates (HR=0.542; 0.389 0.755) non-cACLD HR=0.450; 0.342 0.592), but not HR=0.914; 0.778 1.074). Conclusions relatively

Language: Английский

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The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease

Hepatology International, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 27, 2025

Language: Английский

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Metabolic dysfunction-associated steatotic liver disease in adults

Nature Reviews Disease Primers, Journal Year: 2025, Volume and Issue: 11(1)

Published: March 6, 2025

Language: Английский

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Guideline for the Prevention and Treatment of Metabolic Dysfunction-associated Fatty Liver Disease (Version 2024)

Journal of Clinical and Translational Hepatology, Journal Year: 2024, Volume and Issue: 000(000), P. 000 - 000

Published: Nov. 4, 2024

With the rising epidemic of obesity, metabolic syndrome, and type 2 diabetes mellitus in China, dysfunction-associated non-alcoholic fatty liver disease has become most prevalent chronic disease. This condition frequently occurs Chinese patients with alcoholic hepatitis B. To address impending public health crisis its underlying issues, Society Hepatology Medical Association convened a panel clinical experts to revise update "Guideline prevention treatment (2018, China)". The new edition, titled for (Version 2024)", offers comprehensive recommendations on key including screening monitoring, diagnosis evaluation, treatment, follow-up steatotic Metabolic is now preferred English term used interchangeably Additionally, guideline emphasizes importance multidisciplinary collaboration among hepatologists other specialists manage cardiometabolic disorders effectively.

Language: Английский

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