Please select the option that best describes you:
Topics:
General Internal Medicine • Gastroenterology • General Hepatology • Endocrinology • Diabetes • Lipid Disorders • Hepatology • General Primary Care
In patients with MASLD, would you consider management with off-label metformin, pioglitazone (despite weight gain risk), GLP-1 RA, or simply intensify lifestyle and monitor?
If you prefer monitoring strategy, how frequently do you repeat labs and what is your referral thresholds to hepatology if you're practicing in primary care?
Specifically with GLP1-RA as seen in Phase 3 Trial of Semaglutide in Metabolic Dysfunction-Associated Steatohepatitis
https://www.nejm.org/doi/full/10.1056/NEJMoa2413258
Answer from: at Academic Institution
In 2025, we should be assessing if patients are developing F2-F3 fibrosis especially with the use of non-invasive assessments (FIB-4 score, transient elastography, or MRI elastography), and then offering either Semaglutide or Resmetirom for these individuals w/ F2-F3, which are the only FDA approved...
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