Surfing the MASH Tsunami

Send us Fan Mail This conversation centers around the different kinds of impact that in-office scanning can have on MASLD therapy, both in terms of improved prognostics and better overall outcomes.  Roger Green starts by suggesting that the recent commercialization of a second VCTE in the U.S. (specifically, Hepatoscope from e-Scopics), coupled with increased promotion of the scanning device Velac...

Send us Fan Mail This conversation explores why different nutrition interventions might help MASLD patients improve their overall liver health and what lessons treaters and researchers can learn from this.  It starts with Louise Campbell discussing a recent publication of a pilot study from Armandi et al. (including Jörn Schattenberg as a co-author) evaluating the ability of short-term dietary glu...

Send us Fan Mail This conversation focuses on the role of VCTE in diagnosing, staging and treating MASLD patients, both in terms of prognostic ability of VCTE when compared to biopsy and separately as a therapeutic adjunct. It starts with Hannes Hagstrom and Jörn Schattenberg discussing a study from Vincent Wong and a large group of co-authors, including Hannes,, that compares the abilities or VCT...

Send us Fan Mail Hannes Hagstrom joins Jörn Schattenberg, Louise Campbell and Roger Green to discuss recent research panelists have conducted. This content-dense conversation focuses initially on the impact of VCTE and other forms of in-office monitoring and branches out from there. 00:00:00 - Surf's Up: Season 5 Episode 9 Opening comments from the panel, including brief quotes taken directly...

Send us Fan Mail With Louise Campbell and Jörn Schattenberg both on Easter Week vacations, Fatty Liver Alliance Founder Mike Betel joins Roger Green to continue a brief conversation they began in a post from the Fatty Liver Alliance last weekend. This conversation focuses largely on how patient incentives to participate in MASH clinical trials might need to change now that Rezdiffra is approved. ...

Send us Fan Mail So far, this conversation has focused on Rezdiffra approval and its many forms of impact on MASLD patient advocates. This conversation considers their recommendation for others.  The conversation starts with Roger Green's final question. He asks each panelist to identify a stakeholder group that can take a valuable lesson from this episode and what that lesson should be.  Way...

Send us Fan Mail This conversation asks what impact Rezdiffra patient education might have on a U.S. healthcare system in which 38% of American adults live with some form of MASLD and 15% live with MASH.  Louise Campbell starts off by saying she is “slightly fed up” with the idea that we cannot proceed too quickly for fear of overwhelming the system. Louise would rather flip focus to push systems...

Send us Fan Mail This conversation focuses on how the role of MASLD patient advocates might change and expand in the aftermath of Rezdiffra being approved.   To Wayne Eskridge, this “raises an entirely new field of education and outreach,” because now advocates can do more than merely be supportive emotionally. Advocates can, quoting again, “refresh our message and have broader perspectives and sh...

Send us Fan Mail This conversation focuses on the steps that patient advocates took to educate the FDA on what patients wanted in a MASH drug label, in this case for Rezdiffra.  It starts with Jeff McIntyre reflecting on apparent changes in how the FDA thinks about labeling since the initial obeticholic acid Complete Response Letter in 2020. His specific point: since that first CRL, GLI has worked...

Send us Fan Mail This conversation focuses on advocates' reactions throughout the day on Thursday, March 14, the day Rezdiffra became the first MASH drug approved in the U.S.  Specifically, panelists discuss their thoughts and feelings as they reflected on Rezdiffra’s approval in the context of their personal experience. While no panelist is eligible to receive Rezdiffra as indicated, some th...

Send us Fan Mail This conversation focuses on two issues: (i) identifying the right target MASH patients for Rezdiffra, and (ii) the extensive Madrigal patient support program for Rezdiffra. It starts with Roger Green asking the group how the current set of target patients is defined. Jeff McIntyre points out that these are the patients currently treated for F2 or F3 MASH in the US healthcare syst...

Send us Fan Mail Last Thursday, March 14, Rezdiffra (resmetirom) became the first drug approved in the US for MASH. Five leading North American MASLD patient advocates join the Surfers to discuss their feelings about this approval along with the opportunities and challenges that lie ahead. 00:00:00 - Surf's Up: Season 5 Episode 7 Opening introduction from an excited, enthusiastic panel, inclu...

Send us Fan Mail As the conversation wound down, Roger Green offered panelists to address any issue pertaining to Rezdiffra, the first MASH drug, that had not come up in the hour-long conversation.  The seven panelists raised eleven exceptionally diverse issues between them. Rather than provide a simple list of issues, the co-hosts invite you to listen to this short conversation to gain a fuller a...

Send us Fan Mail This conversation revolves around one question: "What lessons should the BioPharma industry take from the launch of Rezdiffra?" Answers revolve largely around clinical trial design and, generally, taking a broad, long-term view of what the trial must accomplish to optimize drug adoption. More specifically, Roger Green starts this conversation by noting that much of the S...

Send us Fan Mail One pivotal question surrounding the launch of Rezdiffra is "Which MASH patients are the correct targets for the first MASH drug?" This conversation focuses on the tools and education the health system will need to locate these patients and have them treated by the appropriate prescribers.   The conversation starts by considering educational goals. Zobair Younossi asks w...

Send us Fan Mail This conversation focuses on the necessity of using NITs to screen and identify Rezdiffra patients, while at the same time acknowledging the shortcomings of current tests. Panelists suggest some different NIT testing strategies while commenting on upsides and potential challenges for each MASH NIT. Laurent Castera joins the conversation at the beginning, which is helpful given his...

Send us Fan Mail This conversation focuses on what panelists see as a key (and somewhat unusual) benefit of Rezdiffra: that having a prescription drug for MASH creates a better environment for discussing lifestyle intervention and improving overall patient adherence with diet and exercise.     This conversation focuses on the impact of having a drug on getting patients to comply with lifestyle int...

Send us Fan Mail FDA approval of the first MASH drug, Rezdiffra, on March 14 marked what co-host and Key Opinion Leader Jörn Schattenberg describes as a "watershed moment" for hepatology. This opening discussion covers how panelists heard the news of Rezdiffra's approval, how they reacted, and their initial thoughts about appropriate patient targets. As the conversation starts, the...

Send us Fan Mail Last Thursday, March 14, Rezdiffra (resmetirom) became the first MASH drug approved in the US. A global panel of Key Opinion Leaders convenes to discuss their excitement about this approval, the opportunities it will create and some of the (largely manageable) challenges it might present. 00:00:00 - Surf's Up: Season 5 Episode 6 Opening introduction from an excited, enthusias...

Send us Fan Mail This conversation comes from our first look at MASEF, last September, when lead author Mazen Noureddin joined the Surfers to discuss his recent breakthrough paper on this new NIT.  The original conversation had a robust write-up: Mazen Noureddin joins co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to discuss serum identification of at-risk MASH and the Metabolomics-Ad...

Send us Fan Mail After some final discussion about GLP-1s, this conversation entails Roger Green summarizing what he has heard in the episode so far and testing for confirmation or correction. It goes fast and covers significant ground.  Naim Alkhouri starts this conversation by discussing patients for whom he would prescribe resmetirom vs. GLP-1s. Lean MASH patients are likely to receive resmetir...

Send us Fan Mail This conversation touches on two important subjects: the impact of different potential resmetirom prices on the size and structure of the treatable MASH population, and the impact GLP-1s are having (and will have) on clinical trial recruitment and basic patient treatment.  It starts with Naim Alkhouri expressing concern over the $39-52K price he has heard for resmetirom, which ICE...

Send us Fan Mail This conversation focuses more tightly on the specific challenges with the current approaches that use NITs to diagnose and stage advanced MASH fibrosis and explores several newer options and ways of thinking about the challenge. Roger Green notes that recent papers discuss the failure to predict accurately with FIB-4. He asks how we can improve predictive performance. Louise Camp...

Send us Fan Mail This conversation explores the challenges with using the current non-invasive tests (NITs) to diagnose patients with F2/F3 advanced MASH fibrosis. If tests today cannot achieve the requisite level of precision, panelists explore other ways to define patient targets. Roger Green starts by recalling that in a recent episode ( Season 5 Episode 2 ), Jeff McIntyre suggested that in the...

Send us Fan Mail This conversation explores why proper use of non-invasive tests (NITs) will play a pivotal role in increasing the number of patients diagnosed and treated for MASH. It becomes particularly pivotal if, as expected, the first MASH drug is approved later this month. Roger Green starts this conversation by describing why he considers NIT use and adoption one of the two pivotal patient...