2025 Webinar: Resmetirom & Semaglutide for MASH in 2025 (ondemand)-Resmetirom Webinar

Video Transcription

Video Summary

This expert panel discussion, moderated by Dr. Alina Allen, focused on the 2025 management updates for metabolic-associated steatotic liver disease (MASLD) and nonalcoholic steatohepatitis (MASH). Through a clinical case of a 67-year-old woman with biopsy-proven MASH and F3 fibrosis, the discussion centered on contemporary treatment options, emphasizing recently FDA-approved pharmacotherapies: resmetarom and semaglutide.<br /><br />Dr. Nihari Kastamala detailed resmetarom, an oral agent with accelerated FDA approval for non-cirrhotic MASH patients with moderate to advanced fibrosis (F2-F3). It improves histologic endpoints and lipid profiles but requires caution for thyroid disorders and drug interactions, especially cyclosporine and gemfibrozil. Monitoring involves non-invasive liver disease assessments (NILDAs) like transient elastography or MR elastography, with dose adjustments or discontinuation guided by liver enzyme changes and side effects.<br /><br />Dr. Yaron Rotman presented semaglutide, a GLP-1 receptor agonist approved conditionally for non-cirrhotic MASH (F2-F3). Semaglutide induces steatohepatitis resolution and fibrosis improvement and also promotes significant weight loss and glycemic control. Gradual dose titration is essential to manage gastrointestinal side effects; safety monitoring emphasizes kidney function, diabetic retinopathy, and muscle mass preservation. No definitive data exist for cirrhotic patients, thus use is cautious.<br /><br />Dr. Meena Bansal addressed special populations: lean MASH patients benefit from even modest (3-5%) weight loss; people living with HIV have higher MASLD/MASH prevalence and limited data on these agents, with ongoing research; concomitant hepatitis B requires individualized treatment; and women of childbearing age must manage pregnancy risks linked with GLP-1 receptor agonists.<br /><br />Panelists highlighted individualized treatment choice, often shared decision-making weighing injection versus oral therapy, diabetes control, and side-effect profiles. Monitoring response relies on repeated NILDAs and clinical assessments, yet data on treatment duration and discontinuation remain limited. Lifestyle modification remains foundational, especially in patients without significant fibrosis, where pharmacotherapy is generally deferred.<br /><br />Overall, effective MASH management in 2025 integrates pharmacotherapy with careful patient selection, monitoring, and personalized care, considering comorbidities, special populations, and drug safety profiles.

Keywords

MASLD

MASH

resmetarom

semaglutide

F2-F3 fibrosis

FDA-approved pharmacotherapies

non-invasive liver disease assessments

GLP-1 receptor agonist

special populations in MASH

lifestyle modification