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ForumsMASH / Liver DiseaseWhat even is MASH? My doc mentioned it and I panicked — anyone have experience? Page 2

What even is MASH? My doc mentioned it and I panicked — anyone have experience?

CarlaRPh_TPA Wed, Feb 12, 2025 at 3:33 AM 11 replies 1,565 viewsPage 2 of 3
Dr.MetabolicMD
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Feb 13, 2025 at 5:22 AM#6
SarahChen_PharmD said:
Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 338 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible…

Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Baseline: "Moderate hepatic steatosis, liver span 17.2cm, echogenic texture consistent with fat infiltration"
Month 8: "Mild steatosis, liver span 15.8cm, improved echogenicity"
Month 14: "Minimal to no steatosis, normal liver span 14.5cm, normal echotexture"

My liver literally shrank and de-fattened. The ultrasound tech said she's seen this pattern increasingly in GLP-1 patients and it's remarkable how consistently the fatty liver resolves.

2 22SleepDoc_PDX, RegAffairsDC
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Dr.PeteFamMed
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Feb 13, 2025 at 3:39 PM#7
CarlaRPh_TPA said:
ALT was mildly raised at baseline, normalised at month five, and I now have no idea whether anything happened to the fibrosis that actually matters.

NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy. The Phase 2b data for semaglutide showed 59% NASH resolution (vs 17% placebo) with 43% achieving fibrosis improvement[1].

Mechanism: GLP-1R activation reduces hepatic lipogenesis, increases fatty acid oxidation, reduces hepatic inflammation, and may directly reduce hepatic stellate cell activation (fibrosis pathway).

With resmetirom (thyroid hormone receptor agonist) recently approved for NASH, the field is evolving rapidly. Combination approaches (GLP-1 + resmetirom) are being explored.

References:
[1] Newsome PN, et al. N Engl J Med. 2021;384(12):1113-1124.
1 21tommy_boulder
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ingrid_STO
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Feb 14, 2025 at 1:57 AM#8
Dr.MetabolicMD said:
Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

There is a second half to this that has not been said yet. Most of what circulates confidently in this community traces back to one summary of one study, and the qualifier was dropped somewhere in the third retelling.

Last edited: Feb 14, 2025 at 4:57 AM
50 20MikeFit_NJ, InsuranceTom, WendyG_ATL and 47 others
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steph_laguna
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Feb 14, 2025 at 12:15 PM#9

Following on from WendyG_ATL — and this may be the naive question:

Did your prescriber agree with that reading, and if not what was their objection?

49 19DanielChem_CHI, marco_milano, pam_columbus and 46 others
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CarlaRPh_TPA
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Feb 16, 2025 at 1:41 PM#10

OP back with an update, since a thread like this is useless without one.

Reporting back with a partial result, because a partial result is still better than silence. Two of the three things suggested helped; I cannot separate them and I am not going to pretend otherwise.

Last edited: Feb 16, 2025 at 5:41 PM
7 5emily_PDX, Dr.SleepRoch, laura_annarbor and 4 others
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