New Therapies for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD/MASH): Clinical Outcomes and Implementation Challenges
DOI:
https://doi.org/10.51987/Rev.Hosp.Ital.B.Aires.v46i3.1314Keywords:
MASH, MASLD, emerging therapies, liver fibrosis, FXR agonists, GLP-1Abstract
Introduction: metabolic dysfunction-associated fatty liver disease (MASLD) and its progressive inflammatory form, associated steatohepatitis (MASH), represent a growing challenge due to their high prevalence and potential progression to advanced fibrosis and cirrhosis. In recent years, the therapeutic approach has gone beyond lifestyle and dietary measures, driving the development of pharmacological alternatives aimed at modifying the natural history of the disease.
State of the art: recent research has focused on drugs that act on metabolic, inflammatory, and antifibrotic pathways involved in the pathophysiology of MASLD/MASH. Phase II and III clinical trials have shown promising results, notably glucagon-like peptide-1 (GLP-1) receptor agonists and selective thyroid hormone beta receptor agonists, which have shown improvement in the resolution of steatohepatitis and a decrease in the degree of liver fibrosis.
Discussion: despite the advances observed, therapeutic efficacy is not uniform among patients, suggesting pathophysiological heterogeneity and the need for personalized medicine strategies. Questions also remain regarding long-term safety, therapeutic adherence, and cost-benefit ratios in different healthcare settings, which are key aspects for their incorporation into routine clinical practice.
Conclusion: emerging drug therapies for MASLD and MASH represent a significant advance in the management of these conditions, offering significant clinical and histological benefits. However, optimizing their implementation requires further evidence on long-term safety, appropriate patient selection, and strategies to facilitate their effective integration into healthcare systems.
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