Content - Endo and Primary Care MASH Module

Introduction

In this module, Kenneth Cusi, MD, FACP, FACE, discusses best practices in screening for MASLD and MASH according to the guidelines as well as the latest evidence on new and emerging therapies for treating MASLD/MASH in patients with or without diabetes.

The key points discussed in this module are illustrated with thumbnails from the accompanying downloadable PowerPoint slidesets, which can be downloaded here or by clicking any of the slide thumbnails in the module alongside the expert commentary.

Clinical Care Options plans to measure the educational impact of this activity. Some questions will be asked twice: once at the beginning and once at the end of the activity. Your responses will be aggregated for analysis, and your specific responses will not be shared.

Before continuing with this educational activity, please take a moment to answer the following questions.

Pretest 1 Case History

A 54-year-old patient with type 2 diabetes (T2D), obesity (BMI 33kg/m²), and well-controlled hypertension and hyperlipidemia presents for follow-up. Screening for viral hepatitis is negative. The patient does not consume alcohol.

According to current guidelines, what is the most appropriate next step in evaluating this patient?

A.
Refer to hepatology for vibration-controlled transient elastography (VCTE) and liver biopsy
B.
Initiate GLP-1 receptor agonist therapy for potential metabolic dysfunction–associated steatohepatitis (MASH)
C.
Calculate a fibrosis score such as Fibrosis-4 (FIB-4)
D.
Order an MRI-PDFF to quantify hepatic fat content

Which statement best characterizes semaglutide’s therapeutic potential in the management of MASH in patients with cardiometabolic risk factors according to the results of the phase III ESSENCE trial?

A.
Semaglutide significantly improved MASH and fibrosis, confirming dual hepatic and cardiometabolic benefit
B.
Semaglutide significantly improved MASH, weight, and glycemia but did not significantly improve fibrosis
C.
Despite improvements in steatosis, semaglutide failed to demonstrate histologic endpoints required for MASH treatment approval
D.
Semaglutide did not significantly improve MASH or fibrosis, limiting its benefits to weight and glycemia

How often do you currently work with a multidisciplinary team to improve the care of patients with MASLD/MASH?

A.
Never
B.
Rarely
C.
Sometimes
D.
Frequently
E.
Always

How many people with MASH do you provide care for in a typical week?

A.
1-4
B.
5-10
C.
11-15
D.
16-20
E.
>20
F.
Not applicable

For those who practice in academic or community settings, please indicate your practice setting:

A.
Academic
B.
Community

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MASH Matters: New Evidence and Its Application to Endocrinology and Primary Care Practice

Kenneth Cusi, MD, FACP, FACE

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