Envisioning how to advance the MASH field

Area of Science:

• Hepatology and metabolic disease research.
• Public health and policy initiatives for non-communicable diseases.

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern.
• Despite progress, MASLD remains a primary driver of advanced liver disease and liver cancer.
• The recent nomenclature change reflects a deeper understanding of MASLD's metabolic underpinnings.

Purpose of the Study:

• To contextualize the MASLD nomenclature shift and outline strategies for future advancements.
• To propose optimizations for patient care, research, and addressing health disparities in MASLD/MASH.
• To detail regulatory pathways for new MASH therapeutics and enhance health system preparedness.

Main Methods:

• This perspective synthesizes current scientific understanding and clinical observations.
• It reviews progress in drug development and regulatory pathways for MASLD/MASH.
• The approach involves identifying key areas for future research and policy intervention.

Main Results:

• The first MASH-specific drug has been approved, marking a significant milestone.
• Substantial progress has been made in understanding and managing MASLD since 1980.
• Key considerations for accelerating progress include multidisciplinary care, research, and policy.

Conclusions:

• Concerted action is needed to address the public health threat of MASLD and MASH.
• Increased education, awareness, and health system preparedness are vital.
• Achieving parity with other non-communicable diseases requires policy-maker engagement to reduce the burden of MASLD/MASH by 2030.