Non-Invasive MASH Diagnostics & Fibrosis Risk Tools

Identifying & Diagnosing MASH Patients with Non-Invasive Tests

March 2025

In this informative session, Lisa Richards, NP, a hepatology expert from UC San Diego Healthcare, explores how non-invasive tests (NITs) can effectively diagnose metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis without the need for a liver biopsy. She discusses the role of imaging and blood-based biomarkers, such as FibroScan, MRE, ELF, and FIB-4, in identifying patients with stage 2 or higher liver fibrosis and highlights their clinical applications in real-world settings. Lisa walks through a detailed case study, demonstrating how to interpret non-invasive test results, assess risk stratification, and make confident diagnostic decisions using combined NITs like FAST, MEFIB, and MAST scores. She also addresses key limitations of FibroScan and MRI elastography, including BMI constraints, insurance coverage challenges, and patient-specific factors like claustrophobia. Additionally, Lisa introduces clinical care pathways from leading hepatology organizations, explaining how primary care providers and specialists can collaborate to monitor and manage at-risk MASH patients. She emphasizes that, with modern non-invasive tools, biopsies are no longer necessary for diagnosing most MASH patients, enabling earlier intervention and improved patient outcomes.

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Lifestyle Modifications for Patients With MASH

March 2025

In this engaging presentation, Jonathan Yeh, PA, from the Center for Liver Disease and Transplantation at Columbia University, explores the critical role of lifestyle modifications in managing metabolic dysfunction-associated steatohepatitis (MASH). He breaks down the pathogenesis of MASH, explaining how obesity, diabetes, and metabolic dysfunction drive disease progression from steatosis to fibrosis and cirrhosis, and why weight loss and exercise are essential for reversing liver damage. Jonathan highlights the impact of dietary interventions, including the Mediterranean diet, low-carb approaches, and ketogenesis, while emphasizing the importance of calorie restriction over simply eliminating certain food groups. He also discusses the role of exercise, comparing the effectiveness of aerobic training, resistance training, and high-intensity interval training (HIIT) for improving liver health. Surprisingly, research suggests that resistance training may be just as beneficial as aerobic exercise while being more accessible to patients with physical limitations. The discussion also touches on the latest weight loss treatments, including GLP-1 receptor agonists like semaglutide and tirzepatide, which are rapidly transforming obesity management. However, Jonathan underscores that medications alone are not a solution—sustainable lifestyle changes remain the foundation of MASH treatment.

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MASH Bootcamp Q&A

March 2025

In this interactive Q&A session, a panel of liver disease experts discusses key challenges in diagnosing and treating metabolic dysfunction-associated steatohepatitis (MASH) using non-invasive testing and the latest therapeutic advancements. The panel explores the role of FibroScan, ELF scores, and cardiometabolic risk factors in diagnosing fibrosis, especially in patients with limited access to MRI or VCTE-based assessments. They also discuss how serologic testing can be a viable alternative in resource-limited settings and when a liver biopsy may not be necessary for diagnosis. The discussion highlights the FDA approval criteria for Resmetirom, its limitations in F4 patients, and practical strategies for determining treatment eligibility. The experts address real-world challenges, including diagnosing MASH in rural areas, evaluating confounding factors in fibrosis assessment, and ensuring comprehensive liver disease workups to rule out autoimmune conditions.

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Third Step of Life Style Management

January 2025

This video provides a comprehensive overview of emerging pharmacologic treatments for metabolic-associated steatohepatitis (MASH) and their tailored applications based on patient profiles. Topics include FDA-approved therapies, drugs in advanced clinical trials (such as semaglutide and lanifibranor), and the potential for combination treatments targeting both steatohepatitis and fibrosis. The speaker emphasizes the importance of patient-specific approaches considering metabolic profiles, obesity, and diabetes status, alongside lifestyle interventions. Additionally, the video discusses the evolving interdisciplinary care model and highlights the exciting progress in non-invasive testing and treatment advancements for F2-F3 fibrosis.

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Clinical Deep Dive: Unlocking the Treatment Potential of Rezdiffra

March 2025

This educational discussion dives into Rezdiffra, the first and only FDA-approved therapy for non-cirrhotic metabolic-associated steatohepatitis (MASH) with moderate to advanced fibrosis. The talk provides a clinical deep dive into the progression of MASH and fibrosis, highlighting the risks of untreated disease and the importance of early intervention. A key focus is the thyroid hormone receptor beta mechanism, explaining how Rezdiffra directly targets liver-specific pathways to reduce hepatic fat accumulation and fibrosis. Additionally, the discussion covers the rigorous FDA approval process and dual efficacy endpoints, detailing how Rezdiffra achieved significant fibrosis improvement and steatohepatitis resolution in the MAESTRO-NASH trial. The session also provides practical insights into patient access, prescribing considerations, and managing common side effects. With over 2,000 patients studied, Rezdiffra has demonstrated a strong safety profile and offers a once-daily oral treatment option that represents a major advancement in MASH management. This discussion is essential for gastroenterologists, hepatologists, and endocrinologists managing patients with MASH, as well as primary care providers and cardiologists who play a role in identifying at-risk individuals. If you are a healthcare professional looking to stay updated on the latest MASH research and treatment strategies, this session provides the insights you need.

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Types of Diet for the Treatment of MASLD

January 2025

This video explores comprehensive strategies for managing metabolic-associated steatohepatitis (MASH), focusing on fibrosis risk stratification, lifestyle modifications, and pharmacologic interventions. Learn about dietary recommendations like the Mediterranean diet, exercise guidelines emphasizing resistance training, and the role of intermittent fasting and processed food avoidance. The video also highlights weight loss targets, diabetes management, and emerging therapies such as GLP-1 receptor agonists and bariatric surgery, all aimed at improving liver health and patient outcomes.

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Approved Medication for MASH/NASH

January 2025

This video provides detailed guidance on selecting and monitoring patients for emerging therapies targeting advanced fibrosis (F2-F3) in NASH. Key topics include contraindications for patients with cirrhosis, considerations for concomitant medications, and dose adjustments for statins. The video outlines ideal candidates based on specific thresholds for VCTE, MRE, ELF scores, and other non-invasive tests while emphasizing the importance of ruling out portal hypertension and other liver diseases. It also reviews a stepwise monitoring approach, focusing on tolerability at three months and efficacy assessments at six and twelve months, with an emphasis on histologic and non-invasive test improvements.

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Defining, Diagnosing, & Treating MASH

January 2025

Join Jordan Mayberry, PA-C, for an insightful video from the MASH Boot Camp at the 2024 GHAPP National Conference. Jordan covers the latest advancements in diagnosing metabolic-associated steatohepatitis (MASH). She provides a comprehensive overview of the evolution of MASH terminology, the diagnostic criteria, and the critical role of patient history in identifying steatosis. Discover how metabolic risk factors, genetic predispositions, and alcohol consumption influence disease progression. Jordan also explores the importance of non-invasive diagnostic tools, when to consider liver biopsies, and how to differentiate MASH from other liver conditions. Perfect for healthcare professionals seeking to refine their approach to liver disease management.

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Treatment of Metabolic Disorders and the Role of APPs in MASH

March 2025

In this video, April Morris, NP, a specialist in hepatology and endocrinology, discusses the comprehensive management of metabolic syndrome and the critical role of advanced practice providers (APPs) in optimizing patient care. With a multidisciplinary approach, she highlights the importance of weight management, medication selection, and addressing comorbidities such as hypertension, hyperlipidemia, and diabetes to improve metabolic-associated steatohepatitis (MASH) and overall health outcomes. April explores various weight loss medications, including GLP-1 receptor agonists and older alternatives, while emphasizing the need for personalized treatment plans that consider insurance coverage and patient history. She also discusses obesogenic medications that contribute to weight gain and suggests safer alternatives that are weight-neutral or promote weight loss. Managing comorbidities is another key focus, as she explains the importance of blood pressure, cholesterol, and diabetes control in reducing cardiovascular risks. Additionally, she stresses the impact of lifestyle modifications, including diet, exercise, and behavioral interventions, for long-term success. Throughout the discussion, April provides clinical insights into medication-induced weight gain, the barriers to accessing newer treatments, and why collaborative care across specialties, including primary care, endocrinology, hepatology, and bariatric surgery, is essential for effective disease management. For more expert insights, visit RhAPP.org and explore the RhAPP ACE 2.0 App for the latest digital education in metabolic and rheumatologic care.

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Management of Life Style Modification

January 2025

This video focuses on the comprehensive management of patients with metabolic-associated steatohepatitis (MASH), emphasizing lifestyle modifications, dietary adjustments, and exercise strategies. Key topics include the importance of addressing risk factors like diet, exercise habits, and alcohol intake, as well as referrals to medically supervised weight loss clinics or bariatric surgery for advanced cases. The speaker highlights the benefits of the Mediterranean diet, intermittent fasting, and avoiding ultra-processed foods while discussing the role of resistance training to combat sarcopenia and maintain muscle mass. Practical advice and tailored recommendations ensure a holistic approach to managing MASH and improving patient outcomes.

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NITs to Identify High Risk MASH Patients

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Related Video

Identifying & Diagnosing MASH Patients with Non-Invasive Tests

Lifestyle Modifications for Patients With MASH

MASH Bootcamp Q&A

Third Step of Life Style Management

Clinical Deep Dive: Unlocking the Treatment Potential of Rezdiffra

Types of Diet for the Treatment of MASLD

Approved Medication for MASH/NASH

Defining, Diagnosing, & Treating MASH

Treatment of Metabolic Disorders and the Role of APPs in MASH

Management of Life Style Modification