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<p>Metabolic dysfunction-associated steatotic liver disease (MASLD), with its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), is now the most common cause of cirrhosis and hepatocellular carcinoma (HCC). Although the risk of cardiometabolic comorbidities and complications also increases with progressing fibrosis, the prevention and early detection of complications of cirrhosis are of paramount importance in people with MASH-associated liver cirrhosis. This article elaborates on the possibilities and limitations of noninvasive tests for the diagnosis of liver cirrhosis and portal hypertension in MASH. Strategies for preventing decompensation and for HCC screening are highlighted. Furthermore, the specifics of weight management and pharmacotherapy for cardiometabolic risk factors are discussed, and the article concludes with an outlook on potential MASH-specific cirrhosis treatment options currently in late-stage clinical development.</p>

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Mit metabolischer Dysfunktion assoziierte Steatohepatitis bei fortgeschrittener Lebererkrankung und Zirrhose

  • 期刊论文

  • 发表日期：

    2026年7月23日

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  • Paul Horn,
  • Frank Tacke

摘要

Metabolic dysfunction-associated steatotic liver disease (MASLD), with its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), is now the most common cause of cirrhosis and hepatocellular carcinoma (HCC). Although the risk of cardiometabolic comorbidities and complications also increases with progressing fibrosis, the prevention and early detection of complications of cirrhosis are of paramount importance in people with MASH-associated liver cirrhosis. This article elaborates on the possibilities and limitations of noninvasive tests for the diagnosis of liver cirrhosis and portal hypertension in MASH. Strategies for preventing decompensation and for HCC screening are highlighted. Furthermore, the specifics of weight management and pharmacotherapy for cardiometabolic risk factors are discussed, and the article concludes with an outlook on potential MASH-specific cirrhosis treatment options currently in late-stage clinical development.