MASH im Praxisalltag: Von der Diagnose zur lebergerichteten Therapie

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common condition associated with obesity and/or diabetes mellitus, and can develop into the progressive form of steatohepatitis (MASH). Until August 2025, there was no approved therapy for MASH in Germany. Steatohepatitis has a poor prognosis, especially when cardiometabolic risk factors and increased alcohol consumption are present. The challenge in daily practice is to diagnose the precursor stage of MASLD early. The FIB-4 index is a valuable tool in general practice because, using the parameters age, AST, platelets, and ALT, it allows for the identification of at-risk patients who should be referred to a specialist for further evaluation. For patients with MASLD and MASH, weight reduction through effective lifestyle changes, including dietary modifications and exercise, is the most effective and therefore most sustainable treatment. A 10% reduction in body weight within one year can lead to a complete regression of fatty liver. Patients should abstain from alcohol. If MASH with fibrosis grade 2 or 3 is already present, the new THR beta-agonist resmetirome can be used to improve the prognosis. In this podcast, Dr. Martin Fedder presents the key content of an eCME course on the diagnosis and treatment of MASH, moderated by Dr. Luisa Werner and featuring Prof. Münevver Demir. It incorporates essential recommendations from the European Guideline on Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Prof. Demir is a specialist in internal medicine with a focus on gastroenterology and hepatology and works as a senior consultant at Charité University Hospital Berlin. With the kind support of Madrigal Pharmaceuticals Germany GmbH. For eCME training with Prof. Münevver Demir: www.medical-tribune.de/cme-mash-praxisalltag