Date: Oct. 12, 10:30-11:30
Time: 10:30-11:30
Location: B2/L5/5220
Join Professor Zobair Younossi, a leading global expert in liver disease, Chairman of the Global NASH/MASH Council and Professor of Medicine and Chairman of the Global Center for Liver Outcomes & Policy Research at Georgetown University School of Medicine, to explore the growing burden of MASLD and how advances in risk assessment, non-invasive testing and targeted treatments are paving the way for more personalized, precision care.
Please contact Saman Riaz at saman.riaz@kaust.edu.sa to schedule a meeting with the speaker.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is now the most common chronic liver disease, affecting about 38% of adults worldwide (roughly 1.5 billion people) and 55-65% of people with type 2 diabetes (T2D). Some of the highest rates are in the Gulf region, reaching up to 77% among people with T2D living in the region. Yet this population burden hides wide individual variation. Some MASLD patients progress to metabolic dysfunction-associated steatohepatitis (MASH), fibrosis, cirrhosis or hepatocellular carcinoma. Progression is shaped by genetic variants (PNPLA3, TM6SF2, HSD17B13), metabolic drivers, environmental exposures and social determinants of health. In a global MASLD cohort of 17,792 patients with biopsy-proven MASLD, 35% had advanced fibrosis (F3–F4), and T2D was the strongest independent predictor of it (OR 2.42). Fibrosis stage, whether measured by histology or by noninvasive tests (NITs), predicted mortality and liver-related events. Because so many people have MASLD, it has become the most common cause of liver cancer in the United States and the first or second leading indication for liver transplantation in most regions of the world, including Saudi Arabia. Its projected trajectory points to substantial increases in the clinical and economic burden of MASLD across nine countries: the United States, Saudi Arabia, the United Kingdom, Germany, France, Italy, Spain, Brazil and Japan.
Although MASLD affects a large number of people, the key task is to identify those at highest risk of adverse outcomes. These include patients with type 2 diabetes, obesity with complications, or persistently elevated liver enzymes. Fibrosis of stage 2 or higher is an established predictor of mortality. Because liver biopsy is invasive, costly and prone to sampling error, noninvasive tests (NITs) have been developed and are now widely used to risk-stratify these patients.
Precision care therefore begins with finding the patients at highest risk. A stepwise approach is replacing biopsy for risk stratification, treatment selection and monitoring: FIB-4 first, followed by vibration-controlled transient elastography (VCTE), shear-wave elastography or the Enhanced Liver Fibrosis (ELF) test. Current guidance supports treatment within an NIT-defined F2–F3 window (VCTE 8 but <20 kPa, ELF 9.2 but <11.3), with response judged at 12 months using the same tests. Two agents have received accelerated approval for this group. Resmetirom, an oral, liver-directed THR-β agonist, achieved 10-12% placebo corrected fibrosis response in MAESTRO-NASH. Semaglutide 2.4 mg, a weekly GLP-1 receptor agonist, achieved 14% placebo corrected fibrosis response in the ESSENCE trial (n=800), with added weight loss benefit. Mechanismserent mechanisms allow therapy to be matched to phenotype: semaglutide for patients with obesity or T2D, and resmetirom when a liver-directed approach is preferred.
FGF21 analogues, pan-PPAR agonists, dual and triple agonists and THR-β agonists are expanding the treatment options. Meanwhile, outcomes trials are now targeting compensated cirrhosis, which remains the major unmet need. Future treatment will most likely combine several drugs, chosen according to each patient’s genotype, phenotype and other characteristics. Artificial intelligence may help deliver this targeted, personalized therapy, ensuring that each patient receives the right regimen for the right duration. The future of MASLD care is precision care: matching therapy to each patient’s profile and risk, and delivering it through multidisciplinary metabolic clinics that address the full cardio-kidney-liver-metabolic (CKLM) spectrum.
About the speaker
Zobair M. Younossi, MD, MPH, FACP, FACG, AGAF, FAASLD, is Chairman of the Global NASH/MASH Council (2016–present) and Professor of Medicine and Chairman of the Global Center for Liver Outcomes & Policy Research at Georgetown University School of Medicine (2026–present), both in Washington, DC. He also serves as President and Chairman of the Board of the Chronic Liver Disease Foundation (2018–present). He earned his MD from the University of Rochester (Alpha Omega Alpha, 1989), completed an internal medicine residency (1989–1992) and a gastroenterology/hepatology fellowship (1992 1995) at the Scripps Clinic and Research Foundation, and received an MPH from San Diego State University (Hanlon Award and Outstanding Student Award, 1995). After serving as a staff physician and senior researcher at the Cleveland Clinic Foundation in Cleveland, OH (1995–2000), he joined Inova Health System in Falls Church, VA (2000–2026), where he established the Center for Liver Diseases and the Beatty Liver and Obesity Research Program. Over more than a quarter century at Inova, he held senior leadership roles including Chairman of Research (2006–2022); Chairman of Medicine, Inova Fairfax Medical Campus (2011–2024); Vice Chair of the Inova Health System Foundation (2012–2024); and President of Inova Medicine Services (2019–2024). A pioneer in MASLD and translational research, as well as quality-of-life and outcomes research in liver disease, he has authored more than 870 peer-reviewed publications, presented over 1,245 scientific abstracts, and delivered more than 580 invited lectures worldwide. He has a Google Scholar H-index of 162 with more than 181,600 citations, was named a Clarivate Highly Cited Researcher in 2026, and has been ranked by ScholarGPS (2022–2025) as the top scholar worldwide in both liver disease and NAFLD/MASLD.