{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:32:23Z","timestamp":1793140343479,"version":"4.5.0"},"reference-count":54,"publisher":"American Society for Clinical Investigation","issue":"13","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:p>\n                    Metabolic dysfunction\u2013associated steatohepatitis (MASH), the progressive inflammatory form of MASLD, is now a leading cause of chronic liver disease worldwide. Driven by obesity and type 2 diabetes, MASH significantly increases the risk of cirrhosis, hepatocellular carcinoma, and liver failure. While public health interventions remain essential, therapeutic strategies targeting metabolic dysfunction, inflammation, and fibrosis are urgently needed. This Review focuses on pharmacological treatments in advanced development, including incretin-based therapies (GLP-1, dual, and triple agonists), metabolic modulators (PPAR, FGF21, and THR-\u03b2 agonists), and novel agents such as fatty acid synthase inhibitors. Current regulatory approval is based on histological end points, with increasing interest in noninvasive biomarkers and personalized treatment approaches. Recent trials with agents such as semaglutide, tirzepatide, survodutide, lanifibranor, pegozafermin, and resmetirom demonstrate substantial promise in resolving MASH and improving fibrosis, but unresolved issues remain regarding treatment duration, response heterogeneity, and long-term adherence. Genetic variants (e.g.,\n                    <jats:italic>PNPLA3<\/jats:italic>\n                    polymorphisms) and emerging molecular biomarkers may enhance stratification, while artificial intelligence is beginning to shape trial design and drug development. As the field moves toward combination therapies and precision medicine, the definition of therapeutic success will likely evolve to reflect both histological improvement and patient-reported outcomes. This Review provides a timely synthesis of the landscape, challenges, and future directions in MASH therapeutics.\n                  <\/jats:p>","DOI":"10.1172\/jci186425","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T14:00:34Z","timestamp":1751292034000},"source":"Crossref","is-referenced-by-count":79,"title":["Therapeutic horizons in metabolic dysfunction\u2013associated steatohepatitis"],"prefix":"10.1172","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6085-3652","authenticated-orcid":true,"given":"Philip N.","family":"Newsome","sequence":"first","affiliation":[{"name":"Roger Williams Institute of Liver Studies, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London, Foundation for Liver Research and King\u2019s College Hospital, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Loomba","sequence":"additional","affiliation":[{"name":"MASLD Research Center, Division of Gastroenterology and Hepatology, and"},{"name":"Division of Epidemiology, Department of Family Medicine and Public Health, UCSD, La Jolla, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"232","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2023.101133"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0431"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2021.04.015"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.07.033"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00803-X"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2028395"},{"key":"B7","article-title":"Phase 3 trial of semaglutide in metabolic dysfunction\u2013associated steatohepatitis","author":"Sanyal","journal-title":"N Engl J Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2561"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-020-05265-7"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(23)00068-7"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1210\/en.2013-1934"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.174825"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14725"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14551"},{"issue":"3","key":"B15","first-page":"339","article-title":"Qualitative exploration of factors influencing the plan selection process by Medicare beneficiaries","volume":"27","author":"Zhao","year":"2021","journal-title":"J Manag Care Spec Pharm"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00340-0"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15728"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2401943"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/apt.18042"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-1892"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-2151"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2401755"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03018-2"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S358989"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14412"},{"key":"B26","unstructured":"Altimmune. 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