📰 Hepatology Insights with Dr. Chetan R. Kalal

Global Updates | Expert Opinions | Transformative Care

🧠 MAFLD (aka MASLD): 2025 What’s New & What Matters

By Dr. Chetan R. Kalal – Maharashtra’s First DM Hepatologist & Global Leader in Liver Transplant Medicine

The field formerly known as NAFLD is now widely referred to as MASLD under the new “steatotic liver disease (SLD)” umbrella—clarifying the metabolic roots of the condition and streamlining care pathways. (AASLD, Journal of Hepatology)

🔥 2025 Highlights You Should Know

• First GLP-1 approved for MASH: The FDA has cleared semaglutide (Wegovy) for adults with MASH and moderate–advanced fibrosis, marking the first GLP-1 therapy authorized for this disease area. (Wall Street Journal, Reuters)

• Resmetirom remains foundational: Resmetirom (Rezdiffra)—approved in 2024 for non-cirrhotic MASH with fibrosis—continues to anchor pharmacotherapy alongside lifestyle interventions. (U.S. Food and Drug Administration)

• Incretins show histologic impact:

  • Tirzepatide (SYNERGY-NASH): Higher rates of MASH resolution and ≥1-stage fibrosis improvement at 52 weeks vs placebo in Phase 2. (New England Journal of Medicine, PubMed)

  • Semaglutide Phase 3: Reported steatohepatitis resolution benefits vs placebo, reinforcing its role in metabolic-liver care. (New England Journal of Medicine)

• Guideline direction: 2024 EASL–EASD–EASO guidance endorses case-finding in at-risk groups (T2D/obesity) and non-invasive staging (FIB-4 → ELF/FibroScan) to prioritize who needs specialist care. (Diabetologia)

💡 Dr. Kalal’s Care Lens: From Detection to Durable Outcomes

Who to screen: People with type 2 diabetes, central obesity, dyslipidemia, or elevated ALT. Start with FIB-4 in primary care; escalate to ELF/FibroScan with CAP for risk-aligned referrals. (Diabetologia)

Treatment pillars:

• Lifestyle & weight loss (structured coaching; strength + sleep hygiene)

• Pharmacotherapy: Resmetirom for eligible non-cirrhotic MASH with fibrosis; GLP-1/dual agonists (now including Wegovy’s MASH indication) to drive weight, liver fat, and histology benefits; consider tirzepatide where appropriate based on evolving evidence. (U.S. Food and Drug Administration, Wall Street Journal, New England Journal of Medicine)

• Escalation: Endobariatric options for high-risk phenotypes; transplant pathways for decompensation—integrated with cardiometabolic optimization.

🗣️ Dr. Kalal’s Take

“MAFLD/MASLD care is entering a precision era. With non-invasive risk tools and new liver-directed/weight-centric medicines, we can triage smarter, treat earlier, and target histologic endpoints that truly change lives.”

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Mumbai clinics: Andheri, Bandra (Pali Hill), Versova, Khar, Vile Parle

MAFLD/MASLD expert India | Best hepatologist in India | Maharashtra’s first DM hepatologist | FibroScan CAP Mumbai | Resmetirom specialist | Wegovy for MASH | Tirzepatide MASH evidence | Virtual liver consult USA UK Canada Europe UAE Singapore