Metabolic dysfunction-associated steatohepatitis (MASH) impacts a growing number of people worldwide.1 We invite you to learn more about its causes, symptoms and how to improve overall liver health.
At Novo Nordisk, we are acting on our purpose to defeat serious chronic diseases by expanding into new areas. See below how our research and development efforts are addressing the high unmet medical needs of this disease.
It can be difficult to understand the spectrum of metabolic dysfunction–associated steatotic liver disease (MASLD).
MASLD is an umbrella term for conditions caused by the build-up of
extra fat in the liver that is not caused by alcohol
intake.1-3 As fatty liver disease progresses, the liver can
become inflamed (hepatitis) and damaged, which can lead to fibrosis,
or scarring.1-6 If the disease reaches this stage, it is
known as metabolic dysfunction–associated steatohepatitis (MASH),
which is the more severe form of MASLD.4 After years of
damage due to fibrosis, MASH can lead to cirrhosis, which is severe
scarring of the liver and can lead to further complications such as
loss of liver function, liver failure and liver
cancer.1-3,5,6
The exact cause of MASLD and MASH is not known, but it is well
understood that obesity, type 2 diabetes or pre-diabetes, dyslipidemia
and metabolic syndrome are risk factors that make people more likely
to develop these liver conditions.1,2,4,6,7
With the rising prevalence of obesity and type 2 diabetes, both
strong risk factors for MASH, there is projected to be a growing
number of people living with this serious chronic disease
today.1,2,4,6,8
MASH is known as a "silent disease" because it has few or no symptoms, especially in its early stages.9-11 People with MASH may report feeling non-specific symptoms that can easily be mistaken for other conditions. These symptoms can include9-11:
- Abdominal pain, usually in the upper right side
- Back pain
- Fatigue
- Weakness
Because symptoms are often non-specific, it can be challenging to recognize and diagnose MASH. Confirming a diagnosis often requires a variety of tests, including blood tests, imaging and perhaps even a liver biopsy.2,5,6,11
If diagnosed early, lifestyle modifications such as diet and exercise can sometimes successfully pause the progression of MASH, and in some cases – even reverse liver damage in the early stages of the disease.6,8,10,12
Today, there are no cures or limited medicines available to treat MASH, so following a healthy diet and maintaining a healthy weight are essential to managing this disease.1,6,7,12 Most people diagnosed with early-stage MASH will not develop serious complications if managed properly.2,10
If you have this condition, it is important to work with a healthcare professional to come up with a personalized plan for treatment.10,12
At Novo Nordisk, we are committed to meeting this challenge by leveraging our expertise in cardiometabolic disease, obesity and type 2 diabetes along with our ambition to develop new treatment options in people living with MASH. We are supporting advancements of non-invasive diagnostic tests to address challenges in screening, diagnosing and monitoring disease prognosis.
Global Liver Institute. The language of NASH. Accessed August 29, 2023. https://globalliver.org/wp-content/uploads/2022/06/GLI_TheLanguageofNASH_270820.pdf
Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328-357.
Estes C, Razavi H, Loomba R, Younossi Z, Sanyal AJ. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2018;67(1):123-133.
Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73-84.
Tesfay M, Goldkamp WJ, Neuschwander-Tetri BA. NASH: The Emerging Most Common Form of Chronic Liver Disease. Mo Med. 2018;115(3):225-229.
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.
Banini BA, Sanyal AJ. Nonalcoholic Fatty Liver Disease: Epidemiology, Pathogenesis, Natural History, Diagnosis, and Current Treatment Options. Clin Med Insights Ther. 2016;8:75-84.
Neuschwander-Tetri BA. Non-alcoholic fatty liver disease. BMC Med. 2017;15(1):45.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Symptoms & causes of NAFLD & NASH. Accessed September 5, 2023. https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/symptoms-causes
National Health System (NHS). Non-alcoholic fatty liver disease (NAFLD). Updated January 13, 2022. Accessed September 5, 2023. https://www.nhs.uk/conditions/non-alcoholic-fatty-liver-disease/
Rinella ME. Nonalcoholic fatty liver disease: a systematic review [published correction appears in JAMA. 2015 Oct 13;314(14):1521]. JAMA. 2015;313(22):2263-2273.
Hallsworth K, Adams LA. Lifestyle modification in NAFLD/NASH: Facts and figures. JHEP Rep. 2019;1(6):468-479.