Liver cirrhosis in metabolic dysfunction-associated steatohepatitis

Donghyun Ko; Do Han Kim; Pojsakorn Danpanichkul; Masahito Nakano; Chitchai Rattananukrom; Karn Wijarnpreecha; Cheng Han Ng; Mark D Muthiah

doi:10.1093/gastro/goaf037

Liver cirrhosis in metabolic dysfunction-associated steatohepatitis

Gastroenterol Rep (Oxf). 2025 May 2:13:goaf037. doi: 10.1093/gastro/goaf037. eCollection 2025.

Authors

Donghyun Ko¹, Do Han Kim², Pojsakorn Danpanichkul³, Masahito Nakano⁴, Chitchai Rattananukrom⁵, Karn Wijarnpreecha^{6

7

8}, Cheng Han Ng^{4

9

10}, Mark D Muthiah^{10

11

12}

Affiliations

¹ Department of Medicine, Bridgeport Hospital Yale New Haven Health, Bridgeport, CT, USA.
² Department of Medicine, Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
³ Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
⁴ Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
⁵ Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.
⁶ Department of Medicine, Division of Gastroenterology and Hepatology, University of Arizona College of Medicine, Phoenix, AZ, USA.
⁷ Department of Internal Medicine, Division of Gastroenterology and Hepatology, Banner University Medical Center, Phoenix, AZ, USA.
⁸ BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.
⁹ Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
¹⁰ Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore.
¹¹ Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
¹² National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore.

Abstract

In the present narrative review, we have summarized the current evidence on the natural progression of metabolic dysfunction-associated steatohepatitis (MASH) cirrhosis observed through the placebo arm in clinical trials and observational studies. The outcomes scrutinized throughout our review were histology-related changes, non-invasive fibrosis markers, indicators of decompensation, end-stage hepatic complications, and mortality reported during the different clinical trials. Given the short duration of clinical trials, observational studies were included to obtain better insight into the long-term progression and prognosis of MASH cirrhosis. Lastly, new updates about MASH cirrhosis treatments were listed, and the results of these randomized clinical trials were described to enhance our understanding of our current standing in the treatment of MASH cirrhosis.

Keywords: MASH; cirrhosis; observational study; outcomes; progression; randomized clinical trial.

Publication types

Review