Drug Induced Liver Injury & Non-Viral Hepatitis

acute liver failure

abnormal LFTs < 3 months

Common drugs that cause acute liver injury (intrinsic)

APAP

Common drugs that cause acute liver injury (idiosyncratic)

phenytoin and isoniazid

MASLD vs MASH: which has no inflammation?

MASLD

MASLD vs MASH: which has significant inflammation?

MASH

MASLD vs MASH: which has hepatocyte ballooning?

MASH

MASLD vs MASH: which is more severe

MASH

Three metabolic comorbidities that contribute to MASH? What can we do based off these comorbidities to prevent MASH?

• dietary/environmental (lifestyle)

• high fat (obesity)

• genetic contributors

Can prevent by maintaining healthy diet and active lifestyle

Strong risk factors to predict MASH and fibrosis

• age > 50

• T2DM

• first degree relative with MASLD cirrhosis

Treatment for MASH is only for patients with…

stage > 2 fibrosis (early-moderate stage)

Early intervention methods for MASH

• tx comorbidities (ie. GLP1 RA for obesity and diabetes)

• wt loss (exercise and diet)

• dietary modifiers: alcohol, smoking, fructose, coffee

Which trial proved efficacy of GLP-1 use in MASH

Essence trial

Resmetiron indication

MASH with fibrosis stage 2-3

Resmetirom MOA

partial thyroid hormone receptor B-agonist that selectively targets the liver

Name the pivotal study that demonstrated efficacy of resmetirom

MAESTRO-NASH

Resmetirom brand name

Rezdiffra

Resmetiron (Rezdiffa) CI

decompensated cirrhosis