{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:14:37Z","timestamp":1789168477817,"version":"build-2803163510"},"reference-count":66,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Metabolic dysfunction\u2010associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and a leading cause of cirrhosis, hepatocellular carcinoma, and cardiometabolic morbidity. Often clinically silent until advanced fibrosis develops, management has largely relied on lifestyle interventions, with limited pharmacological options and inconsistent risk stratification. Recent advances in noninvasive diagnostics and targeted therapies are beginning to transform this approach. This review examines the evolving management paradigm of MASLD and metabolic dysfunction\u2010associated steatohepatitis (MASH), focusing on practical implementation of fibrosis\u2010based risk stratification, structured care pathways, and newly approved or late\u2010stage pharmacological therapies. Recent clinical trials demonstrate that therapies targeting metabolic dysfunction and hepatic fibrogenesis can improve steatohepatitis and fibrosis, particularly in patients with advanced disease. Incretin\u2010based therapies have shown MASH resolution in approximately 40%\u201360% of patients, accompanied by weight loss of 10%\u201320%, whereas thyroid hormone receptor\u2010\u03b2 agonists have demonstrated substantial reductions in liver fat and improvements in fibrosis\u2010related endpoints. Emerging fibroblast growth factor analogs and combination therapeutic approaches suggest additive benefit through complementary metabolic and anti\u2010fibrotic mechanisms. Together, these advances support treatment strategies guided by fibrosis risk rather than steatosis alone. MASLD care is therefore moving from reactive disease management toward structured pathways that integrate scalable diagnostics with disease\u2010modifying therapy, offering the potential to alter disease progression and reduce the burden of advanced liver disease.<\/jats:p>","DOI":"10.1111\/joim.70143","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:14:51Z","timestamp":1788182091000},"page":"440-460","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Upcoming therapies for steatotic liver disease: Translating breakthroughs into clinical practice"],"prefix":"10.1111","volume":"300","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6085-3652","authenticated-orcid":false,"given":"Philip N.","family":"Newsome","sequence":"first","affiliation":[{"name":"Institute of Liver Studies Kings College Hospital  London UK"},{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1089-1949","authenticated-orcid":false,"given":"Saima","family":"Ajaz","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies Kings College Hospital  London UK"},{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0431"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2024.2445780"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41573-024-01084-2"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lansea.2026.100723"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-025-04079-4"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26041778"},{"key":"e_1_2_11_8_1","volume-title":"FDA approves Rezdiffra\u2122 (resmetirom) for the treatment of nonalcoholic steatohepatitis (NASH) with fibrosis","author":"Madrigal Pharmaceuticals","year":"2024"},{"key":"e_1_2_11_9_1","volume-title":"Resmetirom: EMA recommends approval for the treatment of metabolic dysfunction\u2010associated steatohepatitis (MASH) with fibrosis","author":"European Medicines Agency","year":"2024"},{"key":"e_1_2_11_10_1","volume-title":"Approval letter for Wegovy (semaglutide) injection for the treatment of noncirrhotic metabolic dysfunction\u2010associated steatohepatitis (MASH) with moderate to advanced liver fibrosis","author":"U.S. Food and Drug Administration","year":"2025"},{"key":"e_1_2_11_11_1","unstructured":"EMEA approves GLP\u20101 (Semaglutide) as a medicine used together with diet and physical activity to treat adults with non\u2010cirrhotic metabolic dysfunction\u2010associated steatohepatitis (MASH). 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