Wicked Good Cardiometabolic Chat: Identifying and Managing MASH

Fatty liver disease used to be a footnote in cardiometabolic care; something to mention in passing while focusing on weight, blood sugar, and blood pressure. That, however, has gradually become an approach of the past.

In this episode of Wicked Good Cardiometabolic Chat, hosts Jennifer Goldman, PharmD, CDCES, and Haley Choi, PharmD, BCACP, break down why metabolic dysfunction-associated steatohepatitis (MASH) deserves a permanent seat at the table alongside diabetes, obesity, and cardiovascular disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects roughly a third of adults, up to two-thirds of people with type 2 diabetes, and as many as 70%-80% of people living with obesity. These aren't rare hepatology cases; they're the patients pharmacists see every single day. And what catches a lot of clinicians off guard is that normal liver enzymes don't rule out significant fibrosis.

Goldman and Choi walk through the FIB-4 score, a simple and free tool that uses information already sitting in the chart to help identify patients who need a closer look, and there is no hepatology fellowship required.

From there, the conversation moves into what appropriately selected treatment actually looks like, including where medications like semaglutide, tirzepatide, resmetirom, and pioglitazone fit into the picture, and why lifestyle change remains the foundation no matter what's added on top.

Most importantly, this episode reframes the question pharmacists should be asking: not ‘does my patient have liver disease?’ but ‘could my patient's metabolic disease be affecting the liver?’

Tune in for a practical conversation between colleagues, experts, and friends that you can put to use with your very next patient.

In Wicked Good Cardiometabolic Chat, a podcast offering from Drug Topics, Goldman and Choi aim to empower pharmacists with evidence-based insights into various cardiometabolic topics. All new episodes of Wicked Good Cardiometabolic Chat will be available in a video format via DrugTopics.com on the first Wednesday of each month. Check out our most recent episode: 2026 ADA Diabetes Technology Updates.