In biopsy-confirmed F2 MASH with a lean BMI, what phenotype features (e.g., visceral adiposity, worsening glycemia/prediabetes, atherogenic dyslipidemia) most strongly push you toward a GLP-1 receptor agonist first versus a thyroid hormone receptor-beta agonist first versus upfront combination therapy?

1 Answers

Mednet Member

Hepatology · Mayo Clinic, Rochester, Minn.

I would favor a THR-beta agonist in a patient with atherogenic dyslipidemia and lean MASH as first-line therapy. However, if a patient has significantly impaired glycemic control or poorly controlled diabetes, this phenotype may prompt me to consider a GLP-1 receptor agonist first. I do not start bo...