Clinical and molecular hepatology

Changes in Treatments: From Lifestyle Changes to Targeted Drug Therapies

Updated

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is now the most common chronic liver disease worldwide.

  • Lifestyle modification is essential for managing steatotic liver disease, with the Mediterranean diet being the preferred dietary intervention.
  • Pharmacotherapy has progressed with two FDA-approved options, resmetirom and semaglutide, for noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with moderate-to-advanced fibrosis.
  • Emerging therapies targeting various disease mechanisms are in development, although evidence for metabolic dysfunction- and alcohol-associated liver disease (MetALD) remains limited.
  • Management of MetALD primarily focuses on alcohol cessation and optimizing cardiometabolic risk factors.
  • The field is shifting towards precision medicine, integrating pharmacologic and lifestyle interventions tailored to individual disease characteristics.
  • Key challenges include variability in treatment response and barriers to implementing real-world strategies.

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