New and Emerging Treatments for MASLD/MASH

With the global rise in metabolic dysfunction-associated steatotic liver disease (MASLD), the lack of approved medications is striking.^1,2 Fortunately, during the past year, significant advancements have been made in the US treatment landscape for MASLD. Recent insights into the heterogeneous nature of MASLD have spurred the discovery of novel therapeutic agents and the repurposing of drugs (e.g., semaglutide) available for type 2 diabetes and obesity.^1,3

Although lifestyle modifications like diet and exercise remain the cornerstones of treatment,^1,2,4 effective pharmacologic options have been elusive. Numerous phase 3 trials are underway, and more promising therapies will likely become available within the next few years. In 2024, the FDA conditionally approved resmetirom, a thyroid hormone receptor-β selective drug, for treating non-cirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with moderate to advanced fibrosis.⁴ Although this condition is highly underdiagnosed,⁵ combination therapy may improve outcomes,^1,3,6 with greater efficacy for metabolic treatments initiated in the early stages and for liver-targeting drugs initiated in the advanced stages.³