Metabolic Dysfunction–Associated
Steatohepatitis (MASH)

MASH is a leading cause of liver-related mortality and an increasing burden on healthcare systems globally.1

Additionally, patients with MASH, 
especially those with more advanced metabolic risk factors (hypertension, concomitant type 2 diabetes), are at increased risk for adverse cardiovascular events and increased morbidity 
and mortality.2

Once MASH progresses to moderate to advanced liver fibrosis (stages F2 and F3), the risk of adverse liver outcomes increases dramatically:

  • The risk of liver-related mortality and other liver-related events (e.g. transplant) increases meaningfully in patients with increasing degrees of liver fibrosis. Patients with significant liver fibrosis have an approximately 10-17× increased risk of liver-related mortality versus patients without liver fibrosis.3
  • MASH is rapidly becoming the leading cause of liver transplantation in the US.4
  • People with MASH have an increased risk of heart attack, stroke, and death.2,5

Evolution of MASH/NASH Nomenclature

The naming convention of NASH was first established in 1980.6

  • A comprehensive and inclusive Delphi consensus process was conducted by the AASLD and EASL in collaboration with ALEH, leading to the adoption of the new steatotic liver disease nomenclature: metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH).7
  • This consensus process demonstrated that the patients described using the new nomenclature are relatively indistinguishable from the patients described by the former NASH nomenclature.

NASH and MASH are considered synonymous in this context.

AASLD (American Association for the Study of Liver Diseases);
EASL (European Association for the Study of the Liver);
ALEH (The Latin American Association for the Study of the Liver)

  1. Lazarus JZ, et al. Nat Rev Gastroenterol Hepatol. 2022;19(1):60-78.
  2. Adams LA, et al. Gut, 2017; 66(6):1138-1153.
  3. Dulai PS, et al. Hepatology. 2017; 65(5): 1557–1565.
  4. Younossi ZM, et al. Clin Gastroenterol Hepatol. 2021;19(3):580-589.
  5. Targher G, et al. Diabetes Metab. 2021;47(2):1012154.
  6. Ludwig J, et al. Mayo Clin Proc. 1980;55(7):434-8.
  7. Kanwal F, et al. Hepatology. 2024;79(5):1212-1219.