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MASH

Podcasts

Beyond the Mic: Exploring the Journeys of Leaders.

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Cholestatic Pruritus Across the Age Spectrum: What Are You Missing?

When considering cholestatic pruritus across the age spectrum, a key point to remember is that while the underlying mechanism is similar, pediatric patients often present with unique challenges in diagnosis and management due to factors like limited communication abilities, potential side effects of medications, and the need for careful dosage adjustments; additionally, older adults might have co-morbidities that complicate treatment and require a more nuanced approach to managing pruritus

Podcasts

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NITs in MASH & MASLD – The Future of Early Detection

In this engaging discussion Dr. Alina Allen, from the Mayo Clinic, and Dr. Sonal Kumar, from Weill Cornell Medicine, dive into the evolving role of non-invasive testing (NITs) in the diagnosis and management of steatotic liver disease, including MASLD and fibrosis risk stratification. With the prevalence of fatty liver disease affecting 1 in 3 adults, the experts explore why patients are still being diagnosed too late—and how current gaps in awareness, accessibility, and provider workflow contribute to delays in care. They highlight the limitations of current non-invasive tools like FIB-4 and elastography, emphasize the value of patient empowerment and direct-to-consumer education, and discuss how care pathways, digital technology, and interdisciplinary collaboration can drive earlier detection. This conversation is essential viewing for hepatologists, primary care providers, endocrinologists, and public health professionals working to close the gap in liver disease screening and move toward more equitable, proactive care.
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Understanding Lipodystrophy – A Primer for Hepatologists

In this educational video, Dr. Rebecca Brown, pediatric endocrinologist at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), explores the often-overlooked diagnosis of lipodystrophy—an important condition to consider in patients with steatotic liver disease who present with metabolic complications that seem disproportionate to their degree of obesity.

Dr. Brown discusses when to suspect lipodystrophy in patients with MASLD or NAFLD, especially those who are lean but show signs of insulin resistance, diabetes, hypertriglyceridemia, or low HDL. She explains how lipodystrophy leads to ectopic fat deposition due to the absence or loss of functional adipose tissue, how to examine patients for abnormal fat distribution (particularly in gluteofemoral regions), and when to consider genetic testing or specialty referral.

The video also reviews the role of leptin deficiency in the pathophysiology of lipodystrophy, the clinical use of metreleptin in improving metabolic control, and the current evidence around its effect on liver fat, inflammation, and fibrosis. Dr. Brown emphasizes that lipodystrophy is a clinical diagnosis and encourages hepatologists to keep it on their differential when metabolic disease appears out of sync with body habitus.
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Resmetirom: The First FDA-Approved Therapy for MASH

Thank you Madrigal for your support on this podcast episode.

Join Dr. Steven Flamm, Rush University Medical School, and Dr. Naim Alkhouri, Arizona Liver Health, for an in-depth discussion on Resmetirom — the first FDA-approved treatment for adults with MASH (Metabolic Dysfunction-Associated Steatohepatitis) and moderate to advanced fibrosis. In this expert-led podcast, the panel explores the groundbreaking clinical data behind Resmetirom, including findings from the MAESTRO-NASH trial, which demonstrated fibrosis regression and NASH resolution after just one year of treatment. Drs. Flamm and Alkhouri review real-world patient experiences, optimal use of non-invasive tests (like FibroScan, ELF, and MRI-PDFF), practical monitoring strategies, and common questions on dosing, side effects, and access.

This conversation also addresses treatment selection, synergistic use of Resmetirom with GLP-1 receptor agonists, and how to approach medication continuation or discontinuation in responders. For liver care providers managing patients with MASLD and MASH, this podcast offers valuable guidance on how to incorporate this landmark therapy into practice.
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Webcasts

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Innovations in the Management of MASH

Nadege Gunn, MD, CPI, DABOM
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Advances in Non-Invasive Assessment and Management of MASLD

Rohit Loomba, MD, MHSc
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Expert Perspectives Post Conference Highlights on MASLD/MASH FROM AASLD

Program Overview and Target Audience:
The joint providership of University of Cincinnati College of Medicine (Cincinnati), Chronic Liver Disease Foundation (CLDF), and Gastroenterology & Hepatology Advanced Practice Providers (GHAPP) presents the Expert Perspectives on MASLD/MASH: A 2024 Liver Conference Coverage Series. The initiative will feature an accredited series of livestream meetings following major liver congresses to review and discuss emerging data presented on metabolic dysfunction-associated steatotic liver disease (MASLD) and its subtype metabolic dysfunction-associated steatohepatitis (MASH). The series will be complemented by accredited archived livestreams and educational resources on CLDF’s and GHAPP’s educational portals, chronicliverdisease.org and ghapp.org, respectively, as well as GHAPP’s mobile application, where appropriate. The initiative will target health care professionals (HCPs), including gastroenterologists, hepatologists, nurse practitioners, physician assistants, and nurses.

Educational Objectives:
Upon completion of this activity, participants should be able to:

Discuss emerging data for the diagnosis and monitoring of MASH
Analyze current and potential pharmacologic management strategies for MASH, including GLP-1 agonists
Integrate weight loss into MASLD/MASH disease management strategies

Accreditation Statement:
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Cincinnati, The Chronic Liver Disease Foundation (CLDF), and Gastroenterology & Hepatology Advanced Practice Providers (GHAPP). The University of Cincinnati is accredited by the ACCME to provide continuing medical education for physicians.

The University of Cincinnati designates this enduring activity a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity

Disclosure of Relevant Financial Relationships:
In accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education and the University of Cincinnati policy, all faculty, planning committee members, and other individuals, who are in a position to control content, are required to disclose all relationships with ineligible companies* (commercial interests) within the last 24 months. All educational materials are reviewed for fair balance, scientific objectivity, and levels of evidence. The ACCME requires us to disqualify from involvement in the planning and implementation of accredited continuing education any individuals (1) who refuse to provide this information or (2) whose conflicts of interests cannot be mitigated.

*Companies that are ineligible to be accredited in the ACCME System (ineligible companies) are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant relationships have been mitigated prior to the commencement of this activity. The following disclosures were made:

Planning Committee Disclosures:
Lisa Pedicone, PhD- Medical Writer
No relevant financial relationships to disclose.

Rachel Bejarano, PharmD- Medical Writer
No relevant financial relationships to disclose.
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Publications

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CLDF Payer Coalition Practicum on Metabolic Dysfunction-Associated Steatohepatitis

The Chronic Liver Disease Foundation (CLDF) is a nonprofit organization led by liver disease experts whose purpose is to raise awareness of the effects of chronic liver disease. In 2022, the CLDF formed the “CLDF Health Outcomes
Coalition,” comprised of stakeholders with expertise in liver disease, pharmacoeconomics, public health, health outcomes, managed care organizations, and innovative models of chronic care. In 2022, the coalition held a symposium to address current issues in the management of cirrhosis from overall health outcome and managed care perspectives and published the summary of this symposium, “Addressing Health Outcomes and Rising Costs in the Management of Chronic Liver Disease/Cirrhosis” on the CLDF website, https://www.chronicliverdisease.org/
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The use of current knowledge and non-invasive testing modalities for predicting at-risk non-alcoholic steatohepatitis and assessing fibrosis

There is ongoing recognition of the burden of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH), with fibrosis being the most important histological feature that is associated with progression to cirrhosis and the occurrence of major adverse liver outcomes. Liver biopsy is the gold standard applied to detect NASH and determine the stage of fibrosis, but its use is limited. There is a need for noninvasive testing (NIT) techniques to identify patients considered at-risk NASH (NASH with NAFLD activity score > 4 and ≥ F2 fibrosis). For NAFLD-associated fibrosis, several wet (serological) and dry (imaging) NITs are available and demonstrate a high negative predictive value (NPV) for excluding those with advanced hepatic fibrosis. However, identifying at-risk NASH is more challenging; there is little guidance on how to use available NITs for these purposes, and these NITs are not specifically designed to identify at-risk NASH patients. This review discusses the need for NITs in NAFLD and NASH and provides data to support the use of NITs, focusing on newer methods to non-invasively identify at-risk NASH patients. This review concludes with an algorithm that serves as an example of how NITs can be integrated into care pathways of patients with suspected NAFLD and potential NASH. This algorithm can be used for staging, risk stratification and the effective transition of patients who may benefit from specialty care.

Abstract Library

Unlocking Boundless Knowledge Through Abstracts

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Effects of an anti-lipogenic low-carbohydrate high polyunsaturated fat diet or a healthy Nordic diet versus usual care on liver fat and cardiometabolic disorders in type 2 diabetes or prediabetes: a randomized controlled trial (NAFLDiet).

Fridén Michael (M);Rosqvist Fredrik (F);Kullberg Joel (J);Berglund Lars (L);Vessby Johan (J);Martinell Mats (M);Carlsson Per-Ola (PO);Hulthe Johannes (J);Johansson Lars (L);Ahmad Nouman (N);Johansson Hans-Erik (HE);Rorsman Fredrik (F);Sundström Johan (J);Lind Lars (L);Landberg Rikard (R);Orho-Melander Marju (M);Ahlström Håkan (H);Risérus Ulf (U)

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Increased Risk of Postoperative Complications in Non-Alcoholic Cirrhosis Versus Non-Alcoholic Fatty Liver Disease Following Total Knee Arthroplasty: A National Matched Cohort Study.

Sasaki Jared (J);Hand Catherine (C);Bohn Camden (C);Angotti Morgan (M);Shinn Daniel (D);Lemme Nicholas (N);Forsythe Brian (B)

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Hepatic steatosis detected on low-dose computed tomography in high-risk participants of a lung cancer screening program: a retrospective observational study.

Bonney Asha (A);Chua Michelle (M);Pascoe Diane (D);McCusker Mark W (MW);Steinfort Daniel (D);Sood Siddharth (S);Marshall Henry (H);Brims Fraser (F);McWilliams Annette (A);Stone Emily (E);Fogarty Paul (P);Fong Kwun M (KM);Lam Stephen (S);Manser Renee (R)