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Abstract
Metabolic dysfunction-associated steatohepatitis (MASH) is associated with increased risks of cirrhosis, hepatocellular carcinoma, cardiovascular disease, and chronic kidney disease.
- MASH represents a heterogeneous and systemic disease with varying phenotypes.
- Distinct subsets of MASH include liver-centric phenotypes with rapid fibrogenesis and cardiometabolic phenotypes linked to insulin resistance.
- Recent clinical trials have led to the accelerated approval of pharmacological treatments such as the THRβ agonist resmetirom and the GLP-1R agonist semaglutide for non-cirrhotic MASH with fibrosis.
- Effective treatment strategies may require stratified and possibly combinatorial approaches targeting metabolic dysfunction and fibrogenesis.
- Emerging pharmacotherapies also focus on inflammation and the gut-liver connection, alongside lifestyle interventions.
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