Therapeutic Landscape Evolution: From Lifestyle Interventions to Precision Pharmacotherapy

Area of Science:

• Hepatology and Gastroenterology
• Metabolic and Cardiovascular Health
• Pharmacology and Therapeutics

Background:

• Steatotic liver disease (SLD) is a global health issue, with MASLD being the most prevalent chronic liver disease.
• MASLD is strongly associated with poor cardiovascular health outcomes.
• Current management emphasizes lifestyle changes, including the Mediterranean diet.

Purpose of the Study:

• To review current and emerging therapeutic strategies for SLD.
• To highlight the growing role of precision medicine in managing SLD.
• To discuss challenges and future directions in SLD treatment.

Main Methods:

• Review of recent clinical trials and therapeutic advancements in SLD.
• Analysis of pharmacotherapy options, including FDA-approved drugs and agents in development.
• Exploration of lifestyle interventions and precision medicine paradigms.

Main Results:

• Two drugs, resmetirom and semaglutide, are approved for noncirrhotic MASH with fibrosis.
• Multiple agents targeting various mechanisms are in development for SLD.
• Precision medicine integrating genetics and microbiome data is emerging.

Conclusions:

• The treatment landscape for SLD is rapidly advancing with new pharmacotherapies.
• Personalized treatment strategies are crucial for optimizing patient care across the SLD spectrum.
• Addressing challenges like treatment response heterogeneity and implementation barriers is vital.