Management of MASLD/MASH: challenges, innovations, and the future of patient-centered care in Japan - PubMed

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MASLD prevalence in Japan is projected to rise from 33.7% in 2020 to 44.8% in 2040, driven by an aging population and lean individuals.
A stepwise diagnostic approach is recommended, starting with FIB-4 as first-line NILDA, followed by second-line NILDA like ELF or M2BPGi, and selective liver biopsy.
Management focuses on lifestyle modifications and pharmacological treatments for metabolic comorbidities, with emerging anti-fibrotic and anti-inflammatory therapies on the horizon.
A multidisciplinary care model involving hepatologists, dietitians, psychologists, and others is proposed to provide patient-centered, systemic metabolic care.
Future directions include integrating genomic and metabolomic profiling with NILDA for personalized treatment plans based on real-world data.

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