In patients with a MetALD phenotype and intermittent or underreported drinking, what triggers you to initiate medications for alcohol use disorder versus intensify fibrosis risk stratification (e.g., elastography or serum fibrosis testing) in routine practice?

GLPs have some benefits in AUD, so I default to that choice.

Note: if they have an AUD, they are not metALD; they are ALD with metabolic risk. The AUD is addressed per addiction practice.

None of the other AUD drugs would benefit if the patient has not “bought in,” as they won’t take them.