Questions to ask when starting a new medication for MASH

Formerly known as non-alcoholic steatohepatitis (NASH), metabolic dysfunction-associated steatohepatitis (MASH) is a type of liver disease. MASH belongs to a group of conditions known as steatotic liver disease (formerly known as “fatty liver disease”).

MASH is a more advanced form of metabolic dysfunction-associated steatotic liver disease (MASLD).

MASLD and MASH occur due to a buildup of excess fats in the liver. Under normal circumstances, the liver processes fats consumed in food and produces fats that perform various important functions in the body. For example, the liver produces cholesterols used to build cell membranes and hormones, and it also produces fats that are stored for energy.

When a person has steatotic liver disease, excess fats buildup in the liver, disrupting the organ’s normal function, triggering an inflammatory response by the body’s immune system, and leading to damage and fibrosis (scarring).

With MASH, the disease will have progressed to some amount of inflammation and damage, and possibly fibrosis.

There is a medication to treat MASH

A medication to treat MASH became available in 2024. This medication helps reduce fat accumulation in the liver and may help reduce fibrosis in some cases. It is approved to treat MASH with moderate-to-advanced fibrosis. It is not intended for use in early stages of the disease or in people who have cirrhosis (severe fibrosis that has caused permanent damage to the liver and reduced liver function).

This medication is intended to be used with diet and exercise. Diet and exercise are essential parts of any treatment plan at all stages of this disease. A healthcare provider can guide you on how to make safe, sustainable changes to what you eat and your activity levels.

Medications for other conditions

While there is only one medication specifically indicated for MASH, treatment may involve other medications. While these medications do not treat MASH directly, they will help control risk factors and coexisting conditions that contribute to fat accumulation in the liver, disease progression, and complications.

Other medications that may be a part of a MASH treatment plan:

• Medications used to manage diabetes
• Medications to treat overweight/obesity (such as GLP-1 medications)
• Medications used to help lower cholesterol levels
• Medications that help control blood pressure (hypertension)
• Medications to treat or prevent cardiovascular disease
• Vitamins and nutritional supplements

In other words, treatment for MASH can involve taking multiple medications for multiple reasons. As a person living with MASH or a caregiver, it’s important to know what medications you are taking and why.

What to ask when prescribed a new medication:

• What is the name of the medication?
• Why is this medication recommended? What is the goal of taking this medication?
• What dosage will I be taking?
• How is this medication administered? How often will I need to take this medication and at what times of day?
• How will we know if this medication is working? What can I do to improve my chances of this medication working?
• Is there anything that I need to avoid while taking this medication? Can this medication interact with other medications?
• Is there a risk of side effects? Is there any risk of severe side effects? What symptoms of side effects do I need to watch for? How can side effects be avoided and/or addressed?
• What will this medication cost? Ask what you can do and who you can talk to if you have concerns about the cost of a medication.

You may have other questions, and people with MASH are encouraged to keep a journal or notes on how they feel, what they want to ask their healthcare providers, and things they want to discuss at their appointment. Because MASH affects different people in different ways, your healthcare team will be your best source of information about a diagnosis.

You are also an important source of information for your healthcare team. Your healthcare providers should have an up-to-date list of medications you are taking, including prescription medications, over-the-counter medications, and supplements (including herbal supplements). Your healthcare team should also know if you are having difficulty taking any medication for any reason.