Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease in MASH-Related Cirrhosis

This protocol addresses the management of metabolic dysfunction-associated steatotic liver disease (MASLD) in adults presenting with compensated MASH-related cirrhosis — a stage that requires a distinct, specifically defined clinical approach.

Clinical scenario

The patient carries metabolic dysfunction-associated steatohepatitis (MASH)-related cirrhosis at the compensated stage. This diagnosis shapes which interventions are applicable and which are explicitly not recommended at this point in the disease course.

Pharmacotherapy at the cirrhotic stage

No MASH-targeted pharmacotherapy can currently be recommended for adults with MASH at the cirrhotic stage. Management priorities consequently shift toward a different set of clinical actions tailored to this stage.

Treatment approach — partial overview

Management in this setting may include liver transplantation as a relevant clinical consideration. The structured protocol defines the complete pathway, including all applicable components and the criteria governing each step.

Full regimen details — indications, sequencing, and all management components — are contained in the complete protocol below.

Instant Access to Structured Evidence-Based Regimens

References

  1. No MASH-targeted pharmacotherapy can currently be recommended for adults with MASH at the cirrhotic stage (LoE 5, weak recommendation, strong consensus).
  2. Management of MASH-related cirrhosis includes adaptations of metabolic drugs, nutritional counselling, surveillance for portal hypertension and HCC, as well as liver transplantation in decompensated cirrhosis.
DOI: 10.1016/j.jhep.2024.04.031
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