19/05/2026
We have structured pathways for MASLD and MASH. But from the conversations happening across the field, an important question continues to emerge:
Are current pathways giving clinicians the information they need to act early?
At the American Association of Clinical Endocrinology MASLD & MASH Care Strategic Roundtable, there was strong alignment around fibrosis-based approaches to identify patients at risk of advanced disease. These frameworks are clear, scalable, and an important step forward for broader identification.
At the same time, many of the discussions reflected ongoing challenges in clinical practice.
Even within high-risk cardiometabolic populations, patients are still not always consistently identified or worked up. And when they are, fibrosis often remains the primary lens for decision-making. While fibrosis is critical for understanding accumulated damage, there was significant discussion around whether clinicians also need tools that provide insight into current disease activity and progression.
As earlier intervention becomes a larger focus across the field, that distinction is becoming increasingly important. Questions around how to assess response, interpret discordant results, and make confident decisions earlier in the patient journey continue to surface.
One of the key themes discussed was that many existing tools were originally developed for later-stage hepatology settings, while the clinical questions arising in endocrinology and primary care are often different, focused not only on the extent of liver damage, but also on whether disease is active, progressing, or responding to intervention.
At Perspectum, these discussions closely reflect the areas where we are continuing to focus our innovation and evidence generation efforts: helping support earlier identification, deeper disease characterization, and more informed clinical decision-making.
Grateful to be part of conversations that continue to challenge assumptions and shape how MASLD and MASH care evolves.
