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Review
. 2025 May 2:13:goaf037.
doi: 10.1093/gastro/goaf037. eCollection 2025.

Liver cirrhosis in metabolic dysfunction-associated steatohepatitis

Donghyun Ko  1 , Do Han Kim  2 , Pojsakorn Danpanichkul  3 , Masahito Nakano  4 , Chitchai Rattananukrom  5 , Karn Wijarnpreecha  6   7   8 , Cheng Han Ng  4   9   10 , Mark D Muthiah  10   11   12
Affiliations
Review

Liver cirrhosis in metabolic dysfunction-associated steatohepatitis

Donghyun Ko et al. Gastroenterol Rep (Oxf). .

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.

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Conflict of interest statement

M.D.M. has served as a consultant to Roche, Estella, and Gilead. He has been an advisor for Lerna Bio. M.D.M. has received payment from speaking at Boston Scientific, Olympus Medical, Roche, and Astellas. M.D.M. is supported by the Singapore Ministry of Health through the National Medical Research Council (NMRC) Office, MOH Holdings Pte Ltd under the NMRC Clinician Scientist-Individual Research Grant (MOH-001228) and NMRC Clinician Scientist Award (MOH-001631), as well as the National Research Foundation, Singapore (NRF) under the NMRC Open Fund–Large Collaborative Grant (MOH-001325) and administered by the Singapore Ministry of Health through the NMRC Office, MOH Holdings Pte Ltd. C.H.N. consulted for Boxer Capital.

Figures

Figure 1.
Figure 1.
Summary of progression of MASH cirrhosis in clinical trial vs observational studies.
See this image and copyright information in PMC

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