Fibrosis-Directed MASH Therapeutics Enter the Approved-Drug Era
This narrative review consolidates the evidence base for noninvasive fibrosis staging and the rapidly expanding pharmacotherapy of MASH, giving hepatology pharmacists a framework for stage-specific drug selection now that two agents carry regulatory approval.
MASLD leads global liver disease, now with targeted therapies emerging.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease globally and is linked to significant liver-related complications. The review highlights promising therapies targeting metabolic stress and fibrogenesis, including incretin-based agents and thyroid hormone receptor-β agonists, particularly for advanced fibrosis stages. While lifestyle changes remain foundational, emerging targeted pharmacotherapies offer new options for managing moderate to advanced fibrosis within MASLD, though their long-term impacts need further study. Non-invasive risk stratification and targeted treatments are advancing management of MASLD.
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Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
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