New Global Consensus Roadmap for MASLD: From Risk Identification to Actionable Care

Metabolic dysfunction-associated steatotic liver disease (MASLD) now affects more than one-third of the global adult population and has become an increasingly important driver of cirrhosis, hepatocellular carcinoma, liver transplantation, and liver-related mortality. The newly accepted global consensus recommendations in Clinical Gastroenterology and Hepatology (2026) provide a practical roadmap to help clinicians move from passive disease recognition to proactive, risk-stratified management. Central to this paradigm shift is a fundamental principle: fibrosis risk, rather than steatosis alone, should guide clinical decision-making. Patients with type 2 diabetes, medically complicated obesity, persistent aminotransferase elevation, or multiple cardiometabolic risk factors warrant active risk stratification using first-line noninvasive testing with FIB-4. This approach enables primary care clinicians to rapidly distinguish low-risk patients suitable for routine management from those requiring further assessment and potential specialist referral. The algorithm employs a two-tiered stratification strategy. Second-line noninvasive tests, vibration-controlled transient elastography (VCTE) or the enhanced liver fibrosis (ELF) score, further define disease severity and guide actionable decisions. These tools identify patients with low-risk disease, those with at-risk MASLD and clinically significant fibrosis (F2–F3) where intervention is most impactful, and those with probable cirrhosis who require specialist management. Patients with F2–F3 fibrosis without cirrhosis may be considered for MASH-approved regimens in addition to lifestyle modification. Those with cirrhosis, while not currently candidates for approved MASH pharmacotherapies, should be referred for specialist management, whereas patients with earlier-stage disease (F1) can generally remain under primary care management. Critically, this framework transforms noninvasive tests from diagnostic tools into treatment-enabling instruments. For the first time, the consensus also provides clear threshold-based recommendations for both VCTE and ELF in risk stratification and treatment selection. It further integrates recently approved pharmacotherapies, resmetirom and semaglutide, for appropriate noncirrhotic patients with moderate-to-advanced fibrosis (F2–F3), while emphasizing foundational lifestyle interventions: weight reduction, Mediterranean-style dietary optimization, alcohol minimization, reduction of ultra-processed foods and sugar-sweetened beverages, and regular physical activity. Longitudinal monitoring with repeat noninvasive testing during follow-up or active treatment allows objective assessment of treatment response and refinement of management over time. The future of MASLD care is decisively noninvasive, risk-stratified, scalable, and actionable, combining evidence-based pharmacotherapy with optimized lifestyle modification and comprehensive cardiometabolic risk management for eligible patients. Read the full article: https://www.cghjournal.org/article/S1542-3565(26)00241-7/fulltext

Binge drinking, metabolic dysfunction, and the spectrum of steatotic liver disease in the USA: a cross-sectional and longitudinal analysis

A new study shows that we have been underestimating alcohol related liver disease. Published this week in The Lancet Gastroenterology and Hepatology by members of the Global NASH MASH Council, this large US study using NHANES data from 1988 to 2023 and including 41,100 adults highlights a major issue. Underreporting alcohol use is leading to widespread misclassification of liver disease. Many patients labeled as MASLD may in fact have ALD or MetALD. After adjusting for underreporting, the prevalence of both ALD and MetALD nearly doubled. The mortality signal is striking. Binge drinking drives most premature deaths in ALD at 92.9 percent and contributes significantly in MetALD at 21 percent, while type 2 diabetes remains a major driver in MASLD at up to 44.8 percent. The highest risk occurs when these factors coexist, particularly binge drinking combined with diabetes or hypertension, which is associated with up to a seventeen-fold increase in mortality. The bottom line is clear. We need to move beyond self-reported alcohol intake. Routine assessment of underreported alcohol use with tools such as AUDIT or biomarkers such as PEth, along with careful evaluation of binge drinking patterns, should become standard clinical practice. Misclassification is not benign; it leads to missed opportunities for intervention and underestimates the true burden of disease.

EASL 2026: Accepted Abstracts – Center for Outcomes Research in Liver Diseases

Advancing the Science and Care of Liver Disease: Highlights from the 6th Annual Liver Connect Meeting

The 6th Annual Liver Connect Meeting of the Chronic Liver Disease Foundation was held from February 26–28, 2026, at the Gaylord Pacific Resort & Convention Center in beautiful San Diego, California. The meeting brought together more than 500 in-person attendees, along with a substantial number of virtual participants from across the country and internationally. The scientific program covered the full spectrum of chronic liver diseases, including metabolic dysfunction–associated steatotic liver disease (MASLD), metabolic dysfunction–associated alcohol-related liver disease (MetALD), alcohol-associated liver disease (ALD), cholestatic liver diseases, viral hepatitis, cirrhosis, and pediatric hepatology. Sessions were designed to address both cutting-edge scientific advances and their practical application in clinical practice. Lectures were complemented by highly interactive discussions that engaged participants in thoughtful dialogue around emerging data, evolving therapeutic strategies, and implementation challenges. The meeting also provided valuable opportunities for collaboration and networking among attendees, distinguished faculty, and industry partners, further strengthening the shared commitment to advancing care for patients with chronic liver disease.

Performance of Non-Invasive Fibrosis Tests (NITs) in MASLD Varies by Age, Diabetes, and Obesity: Results from the Global MASLD (G-MASLD) Project from the Global NASH/MASH Council (GNC)

The G-MASLD project with 18,759 biopsy-confirmed MASLD patients from 41 countries has been carried out by members of GNC. The project continues to provide critical data about MASLD/MASH and NITs from real world practices. In this analysis of G-MASLD data, the diagnostic accuracy and performance of NITs were influenced by patient characteristics. FIB-4 performance declined with younger and older age as well as presence of type 2 diabetes, while liver stiffness measurement was mainly affected by obesity. Imaging-based and clinical composite tests, especially Agile-3+ and Agile-4 showed more stable performance across subgroups.

The Global NASH/MASH Council (GNC) at Qatar Health Congress 2026 (January 29–31, 2026)

The Global NASH/MASH Council (GNC) was pleased to collaborate with Qatar Health Congress 2026 to address key topics in MASLD and MASH. The Congress was co-organized under the leadership of Professor Abdel-Naser Elzouki, Chair of the Scientific Committee and a member of the GNC, by the Department of Medicine at Hamad Medical Corporation, in collaboration with the American College of Physicians, Mayo Clinic, and the Royal Colleges of Physicians (Edinburgh, Glasgow, and London), as well as the Global NASH/MASH Council (GNC). The Congress was attended by approximately 2000 participants from Qatar, the Gulf, and across the MENA region and covered a broad range of topics in internal medicine. In collaboration with Qatar Health Congress 2026 and the Steatotic Liver Disease Research Foundation in the MENA region (SLMENA), the GNC organized a dedicated scientific session entitled “From MASLD to MASH: Advances in Diagnosis and Management.” This symposium was highly interactive and featured presentations on MASH delivered by GNC members from the region. In addition, Zobair Younossi delivered a state-of-the-art lecture entitled “The Growing Burden of MASLD and Its Management in 2026: Challenges, Innovations, and Future Directions.” The GNC is delighted to support this very important region of the world in all our activities.

Highlights from Paris International Liver Meeting 2026

The first Paris International Liver Meeting (PILM 2026) was a highly successful three-day scientific conference held from January 19–21, 2026. The meeting featured outstanding scientific sessions covering key areas including MASLD, MetALD, alcohol-associated liver disease, viral hepatitis, hepatocellular carcinoma, cholestatic liver diseases, and complications of cirrhosis. To watch the highlights from the meeting, please click the link below:

The Inaugural Paris International Liver Meeting (PILM 2026)

The first Paris International Liver Meeting (PILM 2026) was organized by Professors Laurent Castera and Zobair Younossi, together with the Scientific Committee. This three-day meeting was attended by 722 participants (449 on site and 273 virtual) from 67 countries and was highly successful. Scientific sessions covered key areas including MASLD, MetALD, alcohol-associated liver disease, hepatocellular carcinoma, viral hepatitis, cholestatic liver diseases, and complications of cirrhosis, and were delivered by internationally recognized experts from across the globe. The program also featured multiple state-of-the-art lectures, numerous lunchtime breakout sessions, an industry corner, and several industry- and CME-sponsored symposia. The meeting provided an excellent platform for interactive discussions and meaningful engagement among colleagues from academia, clinical practice, and industry. The next Paris International Liver Meeting (PILM 2027) is tentatively scheduled for January 18-20, 2027. PILM 2026 was officially endorsed by EASL, the Global Liver Council (GLC), and the Global NASH/MASH Council (GNC).

Inaugural Paris International Liver Meeting 2026: Bringing Cutting-Edge Science and Clinical Practice Together in Liver Disease

We’re excited to take part in the inaugural Paris International Liver Meeting (PILM), held 19–21 January 2026 at the historic Maison de la Chimie in Paris. PILM 2026 will showcase a robust program featuring global leaders in Steatotic Liver Disease (MASLD/MASH, MetALD, ALD), cholestatic liver disease (PBC, PSC), viral hepatitis, and complications of cirrhosis. Each session is designed to promote meaningful exchange across clinical practice, research, and industry. The meeting will include case-based workshops, focused symposia on MASH, cholestatic liver disease, and obesity, and an Industry Corner highlighting the latest therapeutic innovations shaping the future of hepatology. We also look forward to the scientific abstract presentations, offering a valuable platform for researchers to share new insights with peers. We encourage colleagues and trainees to register and submit abstracts to showcase their work. Looking forward to an impactful and inspiring PILM 2026 in Paris!

Major Publications in Hepatology from the Global NASH/MASH Council (GNC)

Members of the Global NASH/MASH Council (GNC) have recently published two major original manuscripts in Hepatology. The GNC Collaborators created the Global-MASLD project, a cohort of 17,792 biopsy-proven MASLD cases with extensive clinical, laboratory, non-invasive test (NIT) data, and long-term outcomes. In the first manuscript, “Global Performance of Non-Invasive Tests in MASLD: Insights from the G-MASLD Study,” the group evaluates the performance of commonly used NITs across different regions of the world. The analysis shows that the diagnostic accuracy of NITs for fibrosis in MASLD varies geographically, with the Agile-3+ and Agile-4 composite scores demonstrating the highest accuracy (link to PDF). The second manuscript, “Predictors of Fibrosis, Clinical Events, and Mortality in MASLD: Data from the Global-MASLD Study,” demonstrates that both histologic stage and fibrosis-related NITs are independent predictors of clinical outcomes in MASLD. Notably, the strength of association was greater for certain NITs than for histology (link to PDF). Together, these studies highlight that NITs are the most clinically relevant predictors of outcomes in MASLD. Both studies support the use of NITs as key endpoints in clinical research and as the most meaningful measures for MASH clinical trials.