Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease in Patients with Dyslipidemia

Clinical Scenario

This protocol applies to metabolic dysfunction-associated steatotic liver disease (MASLD) — formerly termed nonalcoholic fatty liver disease (NAFLD) — occurring in patients who concurrently have dyslipidemia. Lipid management in this population carries particular significance given the cardiovascular risk associated with both conditions.

+ Dyslipidemia

Why Dyslipidemia Shapes Management

Dyslipidemia is a clinically important comorbidity in MASLD. Statin therapy — dosed according to lipid risk levels and atherosclerotic cardiovascular risk — is the established first-line pharmacological approach. Statins are considered safe across the MASLD disease spectrum, including in patients with compensated cirrhosis, and are recommended for cardiovascular risk reduction in this setting.

Treatment Approach — Partial Overview

When statin monotherapy does not achieve therapeutic lipid goals, combination therapy involving a statin together with an additional hypolipemic agent may be considered. The full structured regimen — including which agents to combine, selection criteria, and individualization — is available in the complete protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1097/HEP.0000000000000323

Management of dyslipidemia in NAFLD should include the use of moderate-intensity to high-intensity statins as first-line therapy based on lipid risk levels and atherosclerotic CVD risk scores.
Statins are safe and recommended for CVD risk reduction in patients with NAFLD across the disease spectrum, including compensated cirrhosis.
Combination therapies of statins with other hypolipemic agents, such as ezetimibe, PCSK-9 inhibitors, inclisiran, bempedoic acid, fibrates, omega 3 fatty acids, or icosapent ethyl, should be considered when monotherapy with a statin does not achieve therapeutic goals.

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