What is NASH/MASH?
MASH (metabolic dysfunction-associated steatohepatitis), formerly known as NASH, is the form of fatty liver disease that involves inflammation and liver cell damage. Fat building up in the liver triggers inflammation that can over time lead to scarring (fibrosis) and, in more severe cases, cirrhosis. MASH often causes no symptoms for a long time, so in many cases it is only recognised at a more advanced stage.
What causes NASH/MASH?
MASH is closely linked to metabolic disorders. Its main risk factors include obesity, insulin resistance, type 2 diabetes, high blood pressure and abnormal blood lipids. Genetic factors and lifestyle habits can also play a part. Fat building up in the liver can cause inflammation and cell damage, which in the long term can impair liver function.
What treatments are available?
The basis of MASH treatment is lifestyle change, weight loss, regular exercise and proper treatment of related metabolic conditions. Sustained weight loss can reduce liver fat, inflammation and in some cases fibrosis. In some countries, targeted medicines are already available for certain groups of patients. The efficacy and safety of further new therapies are currently being studied in clinical trials.
What risks does NASH/MASH carry?
One of the main dangers of MASH is persistent inflammation and scarring of the liver, which can lead to advanced fibrosis, cirrhosis, liver failure and in some cases liver cancer. The disease is also associated with increased cardiovascular risk. The likelihood of complications depends greatly on the degree of liver damage and on other conditions present, such as diabetes and obesity.
How is NASH/MASH diagnosed?
Diagnosis is based on a combination of tests. Alongside blood tests, abdominal ultrasound, specialised imaging and tests that measure liver stiffness, such as elastography, can be used. These can help detect fatty liver and liver fibrosis. A definitive diagnosis of MASH sometimes requires a liver biopsy, although non-invasive methods are playing an increasingly important role.
Why are clinical trials important?
Treatment of MASH is a key area of clinical research into liver disease. Studies are investigating new medicines that may reduce liver fat, reduce inflammation and slow or reverse fibrosis. The research aims to evaluate the efficacy and safety of these treatments and to help prevent serious liver disease and its complications.
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