Gastroenterology · Medical Literature
Replacement Text for Funding/Support Section
Abstract
The Review titled “Metabolic Dysfunction–Associated Steatotic Liver Disease in Adults: A Review,” published on January 13, 2026, was corrected to update the funding/support section. The middle of the section has “PNRR (MAD-2022-12375656 project)” that should be “European Union (Next Generation EU-NRRP M6C2-investment 2.1 enhancement and strengthening of biomedical research in the NHS. Project Cod. PNRR-MAD-2022-12375656, title RATIONAL: Risk Stratification of Nonalcoholic Fatty Liver–CUP: I75E22000540006).” This article was corrected online.
Clinical relevance
This JAMA Review (Tilg et al., January 13, 2026) synthesizes current evidence on the pathogenesis, epidemiology, diagnosis, treatment, and prognosis of MASLD — the most common chronic liver disease worldwide — at a pivotal moment when two pharmacologic agents have received conditional FDA approval for MASH with fibrosis. It directly affects a vast and underserved population: MASLD afflicts approximately 30–40% of the global adult population, including up to 60–70% of adults with type 2 diabetes and 70–80% of those with obesity. Clinicians across gastroenterology, endocrinology, cardiology, and primary care must re-orient their approach to this condition given the updated nomenclature, expanded risk-stratification algorithms, and newly approved therapies.
Key findings
1. PREVALENCE: MASLD affects approximately 30–40% of the general adult population globally, with substantially higher rates among individuals with type 2 diabetes (≈60–70%) and obesity (≈70–80%), establishing it as a dominant contributor to chronic liver disease burden worldwide. 2. DISEASE SPECTRUM: MASLD encompasses a continuum from isolated hepatic steatosis to metabolic dysfunction-associated steatohepatitis (MASH), which can progress to cirrhosis, hepatic decompensation (ascites, hepatic encephalopathy, variceal bleeding), and hepatocellular carcinoma; fewer than 10% of patients progress to severe fibrosis or cirrhosis. 3. MORTALITY PATTERN: Cardiovascular disease is the leading cause of death in MASLD, followed by certain extrahepatic cancers (primarily gastrointestinal, breast, and gynecologic) and, to a lesser extent ( 35. NOTE: This summary is derived from the underlying Review article; the submitted abstract was a funding/support correction notice containing no quantitative clinical data, so no effect sizes, CIs, p-values, or NNT/NNH were reported therein.
Practice implications
Clinicians should adopt a sequential, risk-stratified non-invasive approach to fibrosis detection in at-risk patients (e.g., those with type 2 diabetes or obesity), using the FIB-4 index as a first-line screen followed by vibration-controlled transient elastography or MR elastography for indeterminate or abnormal results, reserving liver biopsy for cases where non-invasive staging remains ambiguous. Pharmacologic therapy with resmetirom (80 mg orally once daily if <100 kg; 100 mg once daily if ≥100 kg) or subcutaneous semaglutide 2.4 mg/week should be reserved for patients with confirmed MASH and moderate-to-advanced fibrosis (F2–F3) on a non-cirrhotic background, and clinicians should screen for relevant drug interactions with resmetirom (avoid co-administration with OATP1B1/1B3 inhibitors such as cyclosporine, or strong CYP2C8 inhibitors such as gemfibrozil). Given that cardiovascular disease — not liver failure — is the primary cause of mortality, a multidisciplinary, holistic treatment strategy addressing hepatic, cardiometabolic, and oncologic risk simultaneously is essential for all patients with MASLD.