Expert Opinion on Pharmacotherapy,
Journal Year:
2024,
Volume and Issue:
25(9), P. 1249 - 1263
Published: June 12, 2024
Metabolic
dysfunction-associated
steatotic
liver
disease
(MASLD)
is
defined
by
hepatic
steatosis
and
cardiometabolic
risk
factors
like
obesity,
type
2
diabetes,
dyslipidemia.
Persistent
metabolic
injury
may
promote
inflammatory
processes
resulting
in
steatohepatitis
(MASH)
fibrosis.
Mechanistic
insights
helped
to
identify
potential
drug
targets,
thereby
supporting
the
development
of
novel
compounds
modulating
drivers.
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.