From Basics to Breakthroughs: Advances in MASH Care, With Tessa Janovsky, PA-C

Metabolic dysfunction–associated steatohepatitis (MASH) continues to capture growing attention in hepatology, not only for its rising prevalence but also for its far-reaching consequences.

At the 2025 Gastroenterology & Hepatology Advanced Practice Providers (GHAPP) conference, Tessa Janovsky, PA-C, a physician assistant at Arizona Liver Health, focused on revisiting the fundamentals of MASH while highlighting how the condition extends beyond the liver. With the global and US burden escalating, she emphasized how clinicians are tasked with identifying high-risk patients early, understanding extrahepatic complications, and knowing when to manage in primary care versus referring to specialty care.

“I think it's a really important time in MASH management,” Janovsky told HCPLive, citing recent successes in diagnosing MASH and the importance of early identification of patients with at-risk MASH. “[These include] patients who have a family history of advanced liver disease due to MASH, have diabetes, have obesity… These are the patients that we need to locate in our clinical practice, because they may very well be at risk for advanced fibrosis.”

She says accurate diagnosis and timely referral are crucial, particularly as the treatment landscape begins to shift. With 2 FDA-approved medications now available for MASH, clinicians have new therapeutic tools, but they must also ensure patients are identified and engaged in care to benefit from them.

Even with the availability of resmetirom and semaglutide, Janovsky emphasizes that lifestyle modification remains the cornerstone of MASH management, stressing the importance of nutrient-dense diets, reduced sugar and carbohydrate intake, and consistent physical activity.

Looking ahead, Janovsky says the treatment horizon for MASH is continuing to expand, with agents like FGF21 analogues showing promise in phase 3 trials and excitement building for what combination therapy could bring to the field.

“I think the next few years are going to continue to be super exciting for our MASH patients, and we'll have more options to treat them, because it's not a one size fits all,” she explained. “We need to really take each patient individually and assess what is going to be best for them.”

References

1. Brooks A. Resmetirom (Rezdiffra) Receives Historic FDA Approval for Noncirrhotic NASH. HCPLive. March 14, 2024. Accessed September 19, 2025. https://www.hcplive.com/view/resmetirom-rezdiffra-receives-historic-fda-approval-for-noncirrhotic-nash

2. Brooks A. FDA Approves Semaglutide (Wegovy) Injection 2.4 mg for Noncirrhotic MASH. HCPLive. August 15, 2025. Accessed September 19, 2025. https://www.hcplive.com/view/fda-approves-semaglutide-wegovy-injection-2-4-mg-for-noncirrhotic-mash