Fundamentals of Liver Disease - MASLD-MASLD Podcast

Video Transcription

Video Summary

Transplant hepatologists Jenny Haglund and Matt Odenwald discuss metabolic dysfunction–associated steatotic liver disease (MASLD, formerly NAFLD), which affects 25–30% of adults worldwide and is rising with obesity and diabetes. MASLD is now a leading cause of chronic liver disease, cirrhosis, hepatocellular carcinoma, and liver transplant. Core treatment remains lifestyle-based weight loss, with bariatric surgery historically providing the most durable results. They interview Dr. Mary Rinella, an MASLD expert and ASLD guideline lead author, about emerging therapies. She highlights resmetirom (approved in 2024) as the first drug shown to improve fibrosis in patients with MASH and F2–F3 fibrosis, but notes its narrow indication and the need for more options. GLP-1–based weight-loss drugs improve cardiometabolic outcomes and may enhance response to resmetirom; combination therapy is expected but will take time to validate and approve. Bariatric surgery is now often reserved for patients who cannot tolerate or fail medications. Post-transplant, GLP-1s appear safe, and trials of resmetirom for recurrent/de novo MASLD are forthcoming.

Keywords

MASLD

MASH fibrosis treatment

resmetirom 2024 approval

GLP-1 weight loss drugs

bariatric surgery and liver transplant