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MASH, The Role of Nutrition in Cirrhosis Management, Tessa Janovsky, PA-C and
Before the U.S. Food and Drug Administration approved resmetirom (Resdifla), the first liver-targeting drug Metabolic dysfunction-associated steatohepatitis (MASH) Therapeutically, weight loss served as the cornerstone of disease management.
Despite the availability of pharmacologic therapies for patients with non-cirrhotic MASH, weight loss remains a critical aspect of disease management, with diet and nutrition playing a particularly important role in influencing patient outcomes.
In the presentation 2024 Gastroenterology and Hepatology Advanced Practice Physicians (GHAPP) Annual Meeting Tessa Janofsky, MD, a physician assistant at Arizona River Health in National Harbor, Maryland, discussed the role of nutrition in managing MASH and cirrhosis, calling it “one of the most important discussions I have with my patients.” HCPLive.
“Nutrition can drive outcomes, especially in MASH, when we talk about the need to adjust diet, reduce sugar intake, reduce carbohydrate intake, to reduce the burden of carbohydrates and sugars that the liver has to process, all of which are important for the liver in the long term,” she explained. “When we're talking about cirrhosis, nutrition can make or break a patient's outcome…As long as we can optimize nutrition for our patients, we're setting ourselves up for more success in the future with regards to the liver, morbidity and mortality.”
Yanofsky explained that the best diet is one that patients can follow, noting that it varies from person to person and is not a “one size fits all” approach. Specifically, he called attention to cultural differences in diet that may affect how patients eat and what nutritional changes would be most realistic compared to the diet they are accustomed to.
Acknowledging that both medications and nutrition are mainstays of treatment, Yanofsky noted that resmetirom is approved for use in combination with diet and exercise. He also noted the benefits of diet and exercise for patients with more advanced liver disease, for whom resmetirom is not currently indicated. With regard to diet and nutrition specifically, Yanofsky emphasized the importance of a multidisciplinary approach. Endocrinologist And a nutritionist.
“[Diet] “Medication is a sensitive issue for many patients,” she says. “Even if you just take five extra minutes to talk with them and explore what works for them, they're really grateful. I want to encourage healthcare professionals to think outside the box about what's more relevant to their patients.”
References
- Brooks, A. Resmetirom (Rezdiffra) Receives Historic FDA Approval for Non-cirrhotic NASH. HCPLive. March 14, 2024. Accessed September 12, 2024. https://www.hcplive.com/view/resmetirom-rezdiffra-receives-history-fda-approval-for-noncirrhotic-nash
- Brooks, A. Stephen Harrison, MD: The role of weight loss and resmetirom in the management of NASH. HCPLive. March 18, 2024. Accessed September 12, 2024. https://www.hcplive.com/view/stephen-harrison-md-weight-loss-resmetirom-nash-management
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