Metabolic Dysfunction–Associated Steatotic Liver Disease and Metabolic Dysfunction–Associated Steatohepatitis–Related Fibrosis: Therapeutic Options and Approaches to Treatment

Abstract

Metabolic dysfunction–associated steatotic liver disease (MASLD) is a highly prevalent chronic liver disease impacting one-third of the adult population worldwide. MASLD has substantial associated morbidity and mortality, including progression to cirrhosis with the need for liver transplantation and development of hepatocellular carcinoma. Individuals with metabolic dysfunction–associated steatohepatitis (MASH), the more aggressive subtype of MASLD that includes hepatocyte injury, and stage 2 fibrosis or above are at the highest risk for adverse liver-related outcomes and overall mortality. Identification of high-risk individuals is key as these patients would benefit from directed pharmacotherapy for MASH. Additional directed pharmacotherapy agents are in development for MASH and hepatic fibrosis across various mechanisms of action. This review focuses on therapeutic options for and approaches to treatment in MASLD, including emerging agents.