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CommunityHepatology

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 a monitoring strategy, how frequently do you repeat labs, and what are 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
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What is your first step in management for patients with a new diagnosis of MASLD?

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2 Answers
Mednet Member
Mednet MemberInvited Expert
Hepatology · UCLA
Answered on · Updated on

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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Mednet Member
Mednet Member
Endocrinology · Uchealth Endocrinology Clinic Steamboat Springs
Answered on

The following drugs are approved for MASH:

  1. Semaglutide
  2. Liraglutide
  3. Thiazolidinediones (Pioglitazone, Rosiglitazone)

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