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Therapeutic Landscape Evolution: From Lifestyle Interventions to Precision Pharmacotherapy - PubMed

19 hours ago
  • #Steatotic Liver Disease
  • #Precision Medicine
  • #Pharmacotherapy
  • Steatotic liver disease (SLD), especially metabolic dysfunction-associated SLD (MASLD), is now the most prevalent chronic liver disease globally, closely tied to cardiovascular risks.
  • Lifestyle changes, particularly the Mediterranean diet, are foundational treatments, with new evidence supporting other dietary and exercise approaches.
  • Two FDA-approved drugs, resmetirom and semaglutide, are available for noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with fibrosis, with many more drugs targeting various mechanisms under development.
  • For metabolic dysfunction- and alcohol-associated liver disease (MetALD), management prioritizes alcohol cessation and controlling cardiometabolic factors, with potential therapies like resmetirom, incretin-based treatments, and FGF-21 analogues awaiting full clinical trial evaluation.
  • The field is shifting towards precision medicine that combines lifestyle and drug interventions, customized by disease type, genetics, and gut microbiome, despite challenges like varied treatment responses and implementation issues.