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Current therapeutic landscape and future treatment perspectives of MASH

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Why This Matters

The evolving understanding and classification of MASLD and MASH are crucial for developing targeted treatments and improving patient outcomes. Advances in epidemiology, diagnostics, and consensus on terminology are shaping the future landscape of liver disease management, impacting both the healthcare industry and patients worldwide.

Key Takeaways

Younossi, Z. M., Kalligeros, M. & Henry, L. Epidemiology of metabolic dysfunction-associated steatotic liver disease. Clin. Mol. Hepatol. 31, S32–S50 (2025).

Graupera, I. et al. Prevalence of liver fibrosis in the general population (the LiverScreen project): a multinational European cohort study. Lancet 407, 1448–1458 (2026). This prospective study provides data on the prevalence and risk factors for liver fibrosis in the general population in Europe.

Stroes, A. R., Vos, M., Benninga, M. A. & Koot, B. G. P. Pediatric MASLD: current understanding and practical approach. Eur. J. Pediatr. 184, 29 (2024).

Rinella, M. E. et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J. Hepatol. 79, 1542–1556 (2023). This multisociety international consensus paper establishes the current terminology of MASLD and MASH, replacing former definitions of NAFLD, NASH or MAFLD.

Llovet, J. M. et al. Nonalcoholic steatohepatitis-related hepatocellular carcinoma: pathogenesis and treatment. Nat. Rev. Gastroenterol. Hepatol. 20, 487–503 (2023).

Byrne, C. D., Armandi, A., Pellegrinelli, V., Vidal-Puig, A. & Bugianesi, E. Μetabolic dysfunction-associated steatotic liver disease: a condition of heterogeneous metabolic risk factors, mechanisms and comorbidities requiring holistic treatment. Nat. Rev. Gastroenterol. Hepatol. 22, 314–328 (2025).

Targher, G., Byrne, C. D. & Tilg, H. MASLD: a systemic metabolic disorder with cardiovascular and malignant complications. Gut 73, 691–702 (2024).

Brunt, E. M. et al. Complexity of ballooned hepatocyte feature recognition: defining a training atlas for artificial intelligence-based imaging in NAFLD. J. Hepatol. 76, 1030–1041 (2022).

Ratziu, V. et al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology 128, 1898–1906 (2005).

Bedossa, P. et al. Histopathological algorithm and scoring system for evaluation of liver lesions in morbidly obese patients. Hepatology 56, 1751–1759 (2012).

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