In this episode of Expose MASH [formerly NASH]—intended for US healthcare professionals only— we discuss the role that advanced practice providers (APPs) play in the screening and identification of patients with MASH (metabolic dysfunction-associated steatohepatitis). We explore their influence on patient care, their role in coordinating care, and discuss how their involvement in the MASH patient journey can impact patient outcomes. This episode is brought to you by Novo Nordisk Inc.
In this episode, join experts Deborah Hinnen, NP, RN (Advanced Practice Nurse at Memorial Hospital, University of Colorado), Ann Moore, NP (Nurse Practitioner at Peoria Liver Clinic, Arizona Liver Health), and moderator Mohammad Siddiqui, MD (Professor of Medicine at Virginia Commonwealth University), as they explore the role of advanced practice providers (APPs) in the management of patients with MASH. Our experts will discuss how APPs' contributions can help enhance the patient journey while improving various aspects of patient care, including clinical outcomes and patient satisfaction. Experts will also highlight the vital role APPs play in coordinating care for patients with MASH, by facilitating a multidisciplinary approach across specialties. Tune in to learn about the key contributions APPs make to the MASH treatment landscape.
For more information on MASLD/MASH, click here.
This program is intended for clinicians in the US only. The information presented is aligned with the views and opinions of the speakers and is sponsored by Novo Nordisk Inc. This podcast is not to be used as medical advice and is intended for educational purposes only.
Faculty Presenters:
Deborah Hinnen, NP, RN
Advanced Practice Nurse
Memorial Hospital
University of Colorado
Colorado Springs, CO
Ann Moore, NP
Nurse Practitioner
Peoria Liver Clinic
Arizona Liver Health
Peoria, AZ
Mohammad Siddiqui, MD
Professor of Medicine at Virginia Commonwealth University
Richmond, VA
Click here for full reference list
References
Adams LA, Anstee QM, Tilg H, Targher G. Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases. Gut. 2017;66(6):1138-1153.
Allen AM, Charlton M, Cusi K, et al. Guideline-based management of metabolic dysfunction-associated steatotic liver disease in the primary care setting_. Postgrad Med_. 2024;136(3):229-245.
Aminian A, Al-Kurd A, Wilson R, et al. Association of bariatric surgery with major adverse liver and cardiovascular outcomes in patients with biopsy-proven nonalcoholic steatohepatitis. JAMA. 2021;326(20):2031-2042.
Chakravarthy MV, Neuschwander-Tetri BA. The metabolic basis of nonalcoholic steatohepatitis. Endocrinol Diabetes Metab. 2020;3(4):e00112.
Chen VL, Morgan TR, Rotman Y, et al. Resmetirom therapy for metabolic dysfunction-associated steatotic liver disease: October 2024 updates to AASLD Practice Guidance. Hepatology. 2025;81(1):312-320.
Cusi K, Isaacs S, Barb D, et al. American Association of Clinical Endocrinology Clinical Practice Guideline for the diagnosis and management of nonalcoholic fatty liver disease in primary care and endocrinology clinical settings. Endocr Pract. 2022;28(5):528-562.
Cusi K, Budd J, Johnson E, Shubrook J. Making sense of the nonalcoholic fatty liver disease clinical practice guidelines: what clinicians need to know. Diabetes Spectr. 2024;37(1):29-38.
Ekstedt M, Hagstrom H, Nasr P, et al. Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology. 2015;61(5):1547-1554.
Enslin S. Optimizing the role of advanced practice providers (APPs): Involving APPs in practice operations. Accessed December 10, 2024. https://www.asge.org/home/resources/publications/practical-solutions/practical-solutions-optimizing-the-role-of-advanced-practice-providers-(apps)-involving-apps-in-practice-operations
Estes C, Razavi H, Loomba R, et al. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2018;67(1):123-133.
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 on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. 2024;81(3):492-542.
Gajos A, Tapper EB. The role of advanced practice providers in the care of nonalcoholic fatty liver disease. Clin Ther. 2021;43(3):518-523.
Godoy-Matos AF, Silva Júnior WS, Valerio CM. NAFLD as a continuum: from obesity to metabolic syndrome and diabetes. Diabetol Metab Syndr. 2020;12:60.
Heyens LJM, Busschots D, Koek GH, et al. Liver fibrosis in non-alcoholic fatty liver disease: from liver biopsy to non-invasive biomarkers in diagnosis and treatment. Front Med (Lausanne). 2021;8:615978.
Kanwal F, Shubrook JH, Adams LA, et al. Clinical care pathway for the risk stratification and management of patients with nonalcoholic fatty liver disease. Gastroenterology. 2021;161(5):1657-1669.
Liver Foundation. Accessed May 23, 2025. https://liverfoundation.org/liver-diseases/fatty-liver-disease/nonalcoholic-steatohepatitis-nash/nash-definition-prevalence.
Muthiah MD, Cheng Han N, Sanyal AJ. A clinical overview of non-alcoholic fatty liver disease: a guide to diagnosis, the clinical features, and complications─What the non-specialist needs to know. Diabetes Obes Metab. 2022;24(Suppl 2):3-14.
Piao C, Arteaga EJ, Chen S, et al. Improved detection of fibrotic nonalcoholic fatty liver disease in community-based referrals. Metab Syndr Relat Disord. 2023;21(9):475-478.
Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797-1835.
Rinella ME, Lazarus JV, Ratziu V, et al. NAFLD Nomenclature consensus group. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol. 2023;79(6):1542-1556.
Sanyal AJ, Anstee QM, Trauner M, et al. Cirrhosis regression is associated with improved clinical outcomes in patients with nonalcoholic steatohepatitis. Hepatology. 2022;75(5):1235-1246.
Schattenberg JM, Lazarus JV, Newsome PN, et al. Disease burden and economic impact of diagnosed non-alcoholic steatohepatitis in five European countries in 2018: a cost-of-illness analysis. Liver Int. 2021;41(6):1227-1242.
Schattenberg JM, Allen AM, Jarvis H, et al. A multistakeholder approach to innovations in NAFLD care. Commun Med (Lond). 2023;3(1):1.
Shroff H, VanWagner LB. Cardiovascular disease in nonalcoholic steatohepatitis: screening and management. Curr Hepatol Rep. 2020;19(3):315-326.
Tapper EB, Hao S, Lin M, et al. The quality and outcomes of care provided to patients with cirrhosis by advanced practice providers. Hepatology. 2020;71(1):225-234.
Tapper EB, Krieger N, Przybysz R, et al. The burden of nonalcoholic steatohepatitis (NASH) in the United States. BMC Gastroenterol. 2023;23(1):109.
Targher G, Byrne CD, Lonardo A, Zoppini G, Barbui C. Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: a meta-analysis. J Hepatol. 2016;65(3):589-600.
Vilar-Gomez E, Martinez-Perez Y, Calzadilla-Bertot L, et al. Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis. Gastroenterology. 2015;149(2):367-378.
Younossi ZM, Golabi P, Paik JM, et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology. 2023;77(4):1335-1347.
Younossi ZM, Stepanova M, Al Shabeeb R, et al. The changing epidemiology of adult liver transplantation in the United States in 2013-2022: the dominance of metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease. Hepatol Commun. 2023;8(1):e0352.