Metabolic dysfunction-associated steatotic liver disease - masld

Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a new nomenclature for Nonalcoholic Fatty Liver Disease (NAFLD) proposed by American Association for the Study of Liver Diseases and European Association for the Study of the Liver (AASLD and EASL) in 2023. Recent guidelines from AASLD 2024 and emerging updates from 2025 have redefined diagnostic and therapeutic approaches to MASLD. This article aims to summarize treatment objectives, patient selection, pharmacologic and non-pharmacologic therapies, and follow-up strategies. Result: Lifestyle modification remains the cornerstone of treatment. Pioglitazone and Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 receptor agonists), especially semaglutide, are the first-line pharmacotherapies in selected patients. Resmetirom, recently approved by the FDA and incorporated into the 2025 AASLD guideline, has become a promising therapeutic option for patients with Metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis. Other emerging agents such as lanifibranor are still under investigation in phase III trials. Fibrosis risk stratification using Fibrosis-4 Index (FIB-4), Meta-analysis of Enhanced Liver Fibrosis and FIB-4 (MEFIB), Magnetic Resonance Imaging - Aspartate Aminotransferase Score(MAST) scores aids in determining treatment urgency and monitoring. Conclusion: With improved risk stratification and expanding therapeutic options, individualized care in MASLD will improve long-term outcomes.