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One pivotal question surrounding the launch of Rezdiffra is "Which MASH patients are the correct targets for the first MASH drug?" This conversation focuses on the tools and education the health system will need to locate these patients and have them treated by the appropriate prescribers. 

 The conversation starts by considering educational goals. Zobair Younossi asks what is practical and proceeds to answer his own question.  He starts by pointing out that most early patients will be found in GI practices. This presents a challenge. While hepatologists and their advanced providers have the knowledge they need to identify patients and prescribe, most of the target patients are being treated in gastroenterology practices, and this group is not as knowledgeable about the disease, screening, staging and treatment. For 2024, he says, educating this group must be the primary focus of education. Zobair notes that other specialty organizations are aligned with the need to screen, stage and treat, but the lay practitioners in these specialties also will need education. 

Jeff McIntyre agrees strongly with Zobair’s assessment. Jeff asks: education to what points or outcome? Jeff views education as needing to address two issues: proper prescribing and use of the drug, but also proper identification of patients. To Jeff, these are the key needs in educating gastroenterologists and their advanced providers, but also key issues for educating patients so they can advocate effectively for themselves. 

Jörn Schattenberg states that Rezdifra’s safety profile is a critical benefit. It alleviates some concern that a well-meaning provider might prescribe for a patient with compensated cirrhosis due to a lack of precision with current tests. 

Roger Green notes that the excellent Rezdiffra safety profile will resolve a dilemma physicians have with most first-in-class drugs: how to do no harm while getting the drug to the right patient. This safety profile makes the dilemma less profound, although it is no less important to keep in mind. 

Returning to education, Laurent Castera closes this conversation by noting that he works at a “liver clinic inside a diabetes clinic,” and that the diabetes screening protocol—an annual FibroScan for every patient with suspected advanced liver disease, followed by referral to a hepatologist—is working well.