S5 - E21.3 - The Updated MASLD CPG: Screening, Diagnosing And Managing Patients

Surfing the MASH Tsunami

In this conversation, updated MASLD CPG co-authors Frank Tacke and Elisabetta Bugianesi discuss some of the guidelines' key goals and issues surrounding the screening, diagnosis and management of MASLD patients.
As the conversation starts, co-host Roger Green says that he, too, was impressed that all these adjustments were made within a month at the end of the process. Frank praises the "very engaged Delphi panel" that reacted and voted quickly, and fairly consistently. He proceeds to discuss how the Delphi panel was formed.
From here, the discussion shifts into its key focus: patients. Roger asks for high points in the discussion of screening, diagnosing and managing patients. Elisabetta starts by stating that the resmetirom approval is creating a great push for screening because physicians feel that there is something they can do to help their patients. She describes an approach that begins with FIB-4, proceeds to VCTE and offers two paths for patient management. This should help the system identify patients before cirrhosis or HCC in pre-cirrhotic patients.
Frank points out that this set of guidelines does not rely on biopsy for risk assessment, which he terms "a major breakthrough."
Co-host Louise Campbell lauds the document's approach to diet advice, specifically the broad range of diets that will make it valuable worldwide and for primary care physicians to work from.
Frank adds that the guidelines have adjusted thresholds and other "adaptations to the ethnic background of the individual." This included considering the socioeconomic factors of a target country.