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MASH is a chronic, progressive condition of the liver characterised by worsening liver fibrosis and steatohepatitis, a type of fatty liver disease, which can have life-threatening consequences.1 The condition has a high prevalence in people with overweight and obesity – yet it can often remain undiagnosed.2-7

  

  

“When people say, ‘I have XYZ cancer,’ this has meaning. When people say, ‘I have NAFLD ’† or ‘I have NASH ’† people have no clue what this means” 9

Direct quote from a person living with MASH

NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis.

  

For people living with MASH, obesity significantly increases the risk of further liver health deterioration, as well as impacting physical and mental well-being and quality of life. 3,10

If left untreated, MASH can progress from no fibrosis (F0) to advanced fibrosis (F3) or cirrhosis (F4) in just under 6 years for some patients. 11‡

  

  

An interlinked cardiometabolic condition

  

MASH is closely linked with obesity, as well as other obesity-related complications, such as cardiovascular disease (CVD)4-7

  

  

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People living with MASH have a high prevalence of metabolic comorbidities10

  

Adapted from Younossi Z, et al; 2022.10

When MASH remains undiagnosed, the risks of worsening outcomes and complications increase.8

  

For people with obesity, MASH-related cirrhosis progression can be stopped and even reversed16,17

  

The image shown is a model and not a real patient.

  

International guidelines recommend early screening of at-risk patients § so that MASH can be identified and tackled promptly to prevent further liver damage and associated complications.6,18

Comprehensive MASH care for your patients should include weight management with evidencebased therapies 19,20

  

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Proportion based on the published prevalence of MASH in adults across France, Germany, Italy, Spain and the UK in 2018, which ranged from 11.9% to 12.7% for diagnosed MASH and from 87.3% to 88.2% for undiagnosed MASH.8

†NAFLD is the former nomenclature for metabolic dysfunction-associated steatotic liver disease (MASLD). MASH is the revised terminology for nonalcoholic steatohepatitis (NASH), which better represents the condition’s aetiology.

‡ Fibrosis staging ranges from F0 to F4, with clinically significant fibrosis starting at F2 (moderate fibrosis). Early-stage MASH is F0 or F1 (mild fibrosis), advanced MASH is F3 (advanced fibrosis), and cirrhosis is F4.21,22

§Includes guidelines from the European Association for the Study of the Liver (EASL)–European Association for the Study of Diabetes (EASD)–European Association for the Study of Obesity (EASO) and American Association for the Study of Liver Diseases (AASLD).6,18

  

  

HQ25OB00133 | Approved August 2025

  

References

  1. Singh S, Allen AM, Wang Z, Prokop LJ, Murad MH, Loomba R. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol. 2015;13(4):643-654.
  2. Younossi ZM, Golabi P, Paik JM, Henry A, Van Dongen C, Henry L. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology. 2023;77(4):1335-1347.
  3. Behari J, Wang R, Liu HM, Mckenzie D, Molinari M, Yuan JM. Severe obesity is associated with worse outcomes than lean metabolic dysfunction-associated steatotic liver disease. Hepatol Commun. 2023;7(8):e0741.
  4. Machado M, Marques-Vidal P, Cortez-Pinto H. Hepatic histology in obese patients undergoing bariatric surgery. J Hepatol. 2006;45(4):600-606.
  5. Quek B, Chan TE, Wong ZY, et al. Global prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in the overweight and obese population: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2023;8(1):20-30.
  6. Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(S1):1797-1835.
  7. Tana C, Ballestri S, Ricci F, et al. Cardiovascular risk in non-alcoholic fatty liver disease: mechanisms and therapeutic implications. Int J Environ Res Public Health. 2019;16(17):3104.
  8. Schattenberg JM, Lazarus JV, Newsome PN, et al. Disease burden and economic impact of diagnosed non-alcoholic steatohepatitis in five European countries in 2018: a cost-of-illness analysis. Liver Int. 2021;41(6):1227-1242.
  9. Eskridge W, Cryer DR, Schattenberg JM, et al. Metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis: the patient and physician perspective. J Clin Med. 2023;12(19):6216.
  10. Younossi Z, Aggarwal P, Shrestha J, et al. The burden of non-alcoholic steatohepatitis: a systematic review of health-related quality of life and patient-reported outcomes. JHEP Rep. 2022;4(9):100525.
  11. Loomba R, Adams LA. The 20% rule of NASH progression: the natural history of advanced fibrosis and cirrhosis caused by NASH. Hepatology. 2019;70(6):1885-1888.
  12. Sanyal AJ, Husain M, Diab C, et al. Cardiovascular disease in patients with metabolic dysfunction-associated steatohepatitis compared with metabolic dysfunction-associated steatotic liver disease and other liver diseases: a systematic review. Am Heart J Plus. 2024;14:100386.
  13. Shroff H, VanWagner LB. Cardiovascular disease in nonalcoholic steatohepatitis: screening and management. Curr Hepatol Rep. 2020;19(3):315-326.
  14. Phoolchund AGS, Khakoo SI. MASLD and the development of HCC: pathogenesis and therapeutic challenges. Cancers (Basel). 2024;16(2):259.
  15. Kanwal F, Kramer JR, Mapakshi S, et al. Risk of hepatocellular cancer in patients with non-alcoholic fatty liver disease. Gastroenterology. 2018;155(6):1828-1837.
  16. Caldwell SH, Argo CK. Reversing advanced hepatic fibrosis in NASH: clearly possible but widely at hand? Dig Dis Sci. 2015;60(4):810-812.
  17. Wang S, Friedman SL. Found in translation – fibrosis in metabolic dysfunction-associated steatohepatitis (MASH). Sci Transl Med. 2023;15(716):eadi0759.
  18. European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO). EASL-EASD-EASO clinical practice guidelines on the management of metabolic dysfunction-associated steatotic liver disease.
  19. Cusi K, Isaacs S, Barb D, et al. American Association of Clinical Endocrinology clinical practice guideline for the diagnosis and management of nonalcoholic fatty liver disease in primary care and endocrinology clinical settings: co-sponsored by the American Association for the Study of Liver Diseases (AASLD). Endocr Pract. 2022;28(5):528-562.
  20. Aminian A, Al-Kurd A, Wilson R, et al. Association of bariatric surgery with major adverse liver and cardiovascular outcomes in patients with biopsy-proven nonalcoholic steatohepatitis. JAMA. 2021;326(20):2031-2042.
  21. Clark JM, Cryer DRH, Morton M, Shubrook JH. Nonalcoholic fatty liver disease from a primary care perspective. Diabetes Obes Metab. 2023;25(6):1421-1433.
  22. European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO). EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64(6):1388-1402.

  

 

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