The Importance of Multidisciplinary MASLD Care, with Jonathan Stine, MD, MSc

A comprehensive care team approach may have significant implications for improving metabolic dysfunction-associated steatotic liver disease (MASLD) care, with new research shedding light on the potential utility of a multidisciplinary care model for adult patients with MASLD and significant liver fibrosis.

In March 2024, the US Food and Drug Administration (FDA) granted accelerated approval to Madrigal Pharmaceuticals’ resmetirom (Rezdiffra) for the treatment of noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with moderate to advanced fibrosis, making it the first and only FDA-approved pharmacologic treatment option for the progressive liver disease. However, unmet needs still persist.

“Lifestyle intervention still remains the cornerstone of management, but resmetirom has provided an additional tool for our patients, many of whom are struggling to achieve sufficient weight loss or metabolic improvement through diet and exercise alone,” Jonathan Stine, MD, MSc, an associate professor of medicine and public health science and director of the Fatty Liver Program at Penn State University, told HCPLive.

He noted conversations with patients have evolved over the past year since resmetirom was introduced as a pharmacologic treatment option, citing questions about the need to focus on lifestyle changes if taking a medication.

“As a lifestyle researcher, my answer is absolutely a resounding yes,” he said. “The data still support that diet and exercise are essential for improving liver and metabolic health, and that no single drug is really the magic bullet."

Stine went on to call attention to a growing interest in multidisciplinary approaches to MASLD care due to the fact that it is a multisystem metabolic disorder affecting much more than just the liver. He noted many patients with MASLD also have conditions like obesity, diabetes, high blood pressure, and high cholesterol, all of which can contribute to disease progression but have historically been treated “in isolation” through separate, independent specialists.

“This has been largely ineffective, and that's where the push for multidisciplinary care really comes in,” Stine explained. “The idea is to bring all the necessary expertise, including hepatologists, endocrinologists, obesity medicine specialists, together under one roof to ensure we're addressing the disease comprehensively, rather than just treating it in silos.”

Although multidisciplinary MASLD care has been endorsed by leading hepatology societies, it has not been widely implemented in clinical practice, largely due to a lack of standardization.

“In my opinion multidisciplinary care is here,” Stine said. “But now, the challenge is how do we create a standardized model that we can implement more widely?”

Editors’ note: Stine has relevant disclosures with Astra Zeneca, Galectin, Kowa, Noom Inc., Novo Nordisk, and Zydus Therapeutics.

REFERENCE

Brooks A. Multidisciplinary Care Model Improves Liver, Metabolic Outcomes in MASH. February 20, 2025. Accessed February 26, 2025. https://www.hcplive.com/view/multidisciplinary-care-model-improves-liver-metabolic-outcomes-mash