In MASLD patients with high cardiometabolic risk who already meet a clear metabolic indication for a GLP-1 receptor agonist, how much fibrosis-stage certainty do you require before treating it as liver-directed MASH therapy (and documenting/monitoring it as such), versus starting for metabolic benefit and using NIT trends to decide on subsequent biopsy or add-on liver-specific therapy?

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Mednet Member

Hepatology · Mayo Clinic

If you have the option to get it for type 2 diabetes, it is often more likely to be approved by insurance. There would be no fibrosis requirements and no follow-up on continuing to prove fibrosis staging requirements. Whoever submits for prior authorization can mention if the patient is stage 2 to 3...