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Dr. Joe Galati PodcastDr. Joe Galati PodcastUnderstanding Fatty LiverWelcome to this episode of the Dr. Joe Galati Podcast where we delve into pressing health issues and the latest medical advancements. Today, we have a special guest, Dr. Mazen Noureddin, a world-renowned liver researcher, who joins us for an enlightening conversation about metabolic dysfunction associated with fatty liver disease, a condition that has become a public health crisis globally. As obesity and sedentary lifestyles continue to rise, the prevalence of fatty liver disease has skyrocketed, affecting millions of people worldwide.In this episode, we take a deep dive into the global epidemic of...2025-04-2820 minYour Health FirstYour Health FirstNew York Times Article & Fatty Liver Disease w/ Dr. Mazen NoureddinDr. Galati starts the program by discussing a New York Times article about 17 ways to cut your risk of stroke, dementia, and depression all at once. He also stresses how the common thread of obesity is the leading cause of so many metal health issues or disorders. Dr. Galati also has Dr. Mazen Noureddin join the show to talk about fatty liver disease, second level testing, and more.2025-04-2839 minSurfing the MASH TsunamiSurfing the MASH TsunamiS6 - E4.3 - Expert: Mazen Noureddin Reviews the Exciting MASLD Drug Development EnvironmentThis week's expert, Hepatologist and Key Opinion Leader Mazen Noureddin, joins Roger to discuss major advances in drug development over the past year. He covers a range of different drug classes, focusing on stages of development and the range of options within each class. First, Mazen discusses a tremendously exciting group of FGF-21 agents, specifically mentioning Akero Therapeutics's efruxifermin, 89bio's pegozafermin, and Boston Pharmaceuticals's efimosfermin. He points to efruxifermin’s 96-week results to suggest that FGF-21s might be appropriate for a wide range of patients, the idea that the drug's duration of effect may make the ide...2025-04-1324 minSurfing the MASH TsunamiSurfing the MASH TsunamiS6 - E4 - Reasons for optimism in MASLD drug development and patient advocacy00:00:00 - Surf's Up: Season 6 Episode 4 Surfing the MASH Tsunami concludes its coverage of the AASLD Emerging Trends Conference on MASLD, MetALD and ALD. This week, the panelists focus on pivotal messages that attendees took away from the conference and what messages they would like to share with listeners. Our newsmaker, Fatty Liver Alliance and CEO Mike Betel, discusses the lessons he has taken from being invited to a far wider swath of conferences this year and shares the messages he delivers to these new audiences. Finally, our expert, hepatology research and key opinion leader Mazen Noureddin, discusses r...2025-04-111h 12Expose MASH [Formerly NASH]Expose MASH [Formerly NASH]Why MASH Screening Matters: Preventing Fibrosis ProgressionOn this episode, join experts Mazen Noureddin, MD, MHS (Transplant Hepatologist and Professor of Medicine at Houston Methodist Hospital), Kris Kowdley, MD (Director, Liver Institute Northwest) and Mitchell Shiffman, MD, (Hepatologist, Bon Secours Health System in Richmond, Virginia), as they discuss the importance of identifying and referring patients at risk for MASH with clinically significant fibrosis (≥F2). Our experts will discuss the liver specialist perspective on the urgency for specialty referral of appropriate patients, including the increased morbidity and mortality associated with advancing liver fibrosis. They will explain ways to identify patients at risk for clinically significant fibrosis and wi...2024-12-1020 minExpose MASH [Formerly NASH]Expose MASH [Formerly NASH]A Practical Translation Guide: Turning MASH Guidelines Into PracticeOn this episode, join experts Mazen Noureddin, MD, MHS (Transplant Hepatologist and Professor of Medicine at Houston Methodist Hospital), Rita Basu, MD (Endocrinologist and Endowed Professor of Diabetes Scienceat University of Alabama at Birmingham) and Mary Rinella, MD (Transplant Hepatologist and Professor of Medicine at The University of Chicago Medicine), as they explore the most recent MASH guidelines. The experts discuss the different guidelines available, examining their common features and subtle differences for patient screening and the management of MASLD and MASH. They then look to the future, highlighting the emerging data that may influence the next iterations of th...2024-10-1720 minExpose MASH [Formerly NASH]Expose MASH [Formerly NASH]Exploring FIB-4 for Fibrosis Risk AssessmentOn this episode, join experts Mazen Noureddin, MD, MHS (Transplant Hepatologist and Professor of Medicine at Houston Methodist Hospital), Jay Shubrook, DO, FACOFP, FAAFP (Diabetologist and Professor of Medicine at Touro University California) and Mohammad Siddiqui, MD (Gastroenterologist/Hepatologist and Associate Professor at Virginia Commonwealth University), in a discussion that highlights the significance of noninvasive tests in screening patients who are at risk for MASH. These experts enlighten us on how to incorporate the FIB-4 index in clinical practices for fibrosis risk assessment and how the scores generated are used to provide recommendations for further management approaches. The conversation f...2024-10-0220 minExpose MASH [Formerly NASH]Expose MASH [Formerly NASH]Empowering Patients: Strategies for Education on Liver HealthOn this episode, join experts Mazen Noureddin, MD, MHS (Transplant Hepatologist and Professor of Medicine at Houston Methodist Hospital), Sarah Enslin, PA-C, (Physician Assistant, Gastroenterology and Hepatology at the University of Rochester Medical Center), and Lisa Richards, FNP-BC, MSN (Hepatology Nurse Practitioner at the University of California San Diego), in a discussion on their approaches to educating patients about MASH and overall liver health. The conversation will examine the importance of educating patients on the disease and how effectively communicating with patients can help raise awareness of MASH, increase screening, and improve diagnosis rates and management of this condition...2024-09-1920 minExpose MASH [Formerly NASH]Expose MASH [Formerly NASH]Connecting Metabolic Dots in the Context of MASHOn this episode, join experts Mazen Noureddin, MD, MHS (Transplant Hepatologist and Professor of Medicine at Houston Methodist Hospital), Fernando Bril, MD (Endocrinologist and Assistant Professor of Medicine at University of Alabama at Birmingham) and Bubu Banini, MD, PhD, (Hepatologist/Gastroenterologist and Assistant Professor of Medicine at Yale), as they explore the connection between MASH and other metabolic diseases, including obesity and type 2 diabetes. The experts discuss the shared metabolic dysfunction among these conditions and the increased prevalence of MASH in patients with other cardiometabolic risk factors. As MASH is frequently (though not always) a progressive yet often asymptomatic...2024-09-0515 minExpose MASH [Formerly NASH]Expose MASH [Formerly NASH]The MASH Journey: Today, Tomorrow, and BeyondWhat is the journey for a patient with MASH? Please join experts Mazen Noureddin, MD, MHS (Transplant Hepatologist and Professor of Medicine at Houston Methodist Hospital), Kenneth Cusi, MD, FACP, FACE (Endocrinologist and Professor of Medicine at the University of Florida) and Jay Shubrook, DO (Professor of the Primary Care Department at Touro University California) as they discuss patient care in MASH. They will examine the importance of early identification, the tools available to assist with this, and the management options available once fibrosis risk has been assessed. They will also provide insight into the importance of a multidisciplinary...2024-08-0922 minExpose MASH [Formerly NASH]Expose MASH [Formerly NASH]MASH Crossroads: The Liver and Patients at RiskWhat is the connection between cardiometabolic dysfunction and MASH? Please join experts Mazen Noureddin, MD, MHS (Transplant Hepatologist and Professor of Medicine at Houston Methodist Hospital), Meagan Gray, MD (Transplant Hepatologist and Assistant Professor of Medicine at the University of Alabama at Birmingham) and Marcelo Kugelmas, MD, FAASLD, FACP (Director of Hepatology and Research at South Denver Gastroenterology), as they discuss the latest perspectives on MASH and how it can lead to improvements in patient care. The experts will provide insights on how to best use current guidelines to identify at-risk patients and how they collaborate with other specialists...2024-07-2413 minExpose MASH [Formerly NASH]Expose MASH [Formerly NASH]MASH is the New NASHLet’s dive into the world of MASH together. On the first episode of this series, please join experts Mazen Noureddin, MD, MHS (Transplant Hepatologist and Professor of Medicine at Houston Methodist Hospital), Amreen Dinani, MD, MSc (Hepatologist and Associate Professor of Medicine at Duke University) and Sonal Kumar, MD, MPH (Clinical Director of Hepatology and Gastroenterology at Weill Cornell Medical College), as they provide an overview of MASH (formerly called NASH). The experts will discuss the epidemiology and pathophysiology of MASH, including comorbidities, as well as the importance of recognizing MASH as a cardiometabolic disorder. The discussion will al...2024-07-0914 minSurfing the MASH TsunamiSurfing the MASH TsunamiS5 - E20.5 - Drug Development Highlights From EASL Congress 2024: Denifenstat, SPECIAL and Other StoriesMazen Noureddin and Naim Alkhouri join Jörn Schattenberg and Roger Green to discuss some of the other major drug development stories from the EASL Congress 2024, with special focus on denifenstat, ION-224 and TAK-227, and to review the SPECIAL study on bariatric surgery and cirrhosis. The panelists concur that all three of these agents have potential value in therapy. Naim expresses some concern about how broad denifestat use will be based on its side effect profile. Later in this conversation, Mazen belives that denifenstat has broad potential for use, given that the most prominent side effect, hair th...2024-06-2313 minSurfing the MASH TsunamiSurfing the MASH TsunamiS5 - E20.4 - Drug Development Highlights From EASL Congress 2024: Are FGF-21s Induction Therapy or a "MASH Cure"?Mazen Noureddin and Naim Alkhouri join Jörn Schattenberg and Roger Green to focus on the role FGF-21s will play in long-term advanced fibrosis treatment: induction or long-term therapy...or might we even think of the class as being able to produce a "MASH cure?" Responding to Naim's comment closing the previous discussion, Mazen questions why we regard FGF-21 agents as induction therapies given that it appears to be as well tolerated as the oral agents and maintains such efficacy over time. In fact, he adds, its sustained efficacy might make it possible for livers to el...2024-06-2310 minSurfing the MASH TsunamiSurfing the MASH TsunamiS5 - E20.3 - Drug Development Highlights From EASL Congress 2024: "Twin-cretins" and efruxiferminNaim Alkhouri and Mazen Noureddin join Jörn Schattenberg and Roger Green to discuss issues regarding incretin agonists and results from the efruxiermin late-breaker at the EASL Congress 2024. Naim shares his general excitement about glucagon agents in general. He mentions that the efinopegdutide study included a semaglutide cell, which showed further reduction in liver fat vs. the GLP-1 agent. Jörn comments on the high level of tolerability in the survodutide trials. Mazen shares his high hopes for GLP/glucagons and the triple agents. He goes back to review the survodutide data from the NEJM ar...2024-06-2214 minSurfing the MASH TsunamiSurfing the MASH TsunamiS5 - E20.2 - Drug Development Highlights From EASL Congress 2024: Tirzepatidate and other "Twin-cretins"Mazen Noureddin and Naim Alkhouri join Jörn Schattenberg and Roger Green to discuss the tirzepatide late-breaker at the EASL Congress 2024 and other "Twin-cretins," all of which are GLP-glucagon combinations. "Twin-cretins" is the name Jörn has coined for agents with a GLP-1 agonist plus another incretin effect. Tirzepatide is a GLP/GIP agent, while survodutide and the agents discussed last year, pemvidutide and efinopegdutide, are GLP/gluagons. Naim reviews the results of the tirzepatide late-breaker presentation. As expected, it showed high rates of MASH resolution. Naim does not feel it answered the question whether an i...2024-06-2211 minSurfing the MASH TsunamiSurfing the MASH TsunamiS5 - E20.1 - Drug Development Highlights From EASL Congress 2024: ResmetiromNaim Alkhouri and Mazen Noureddin join Jörn Schattenberg and Roger Green to discuss some of the new research on resmetirom at the EASL Congress 2024.Mazen begins this discussion by covering a paper he presented on Stephen's behalf, looking at dose-response with resmetirom. The analysis indicated that PDFF and histology improvements at the 100mg dose were greater than at the 80mg dose. Mazen speculates that the higher dose might provide a greater anti-fibrotic response as well, although, in a world where biopsy is not required for prescribing, he doubts the study will ever be done.  Jörn not...2024-06-2210 minSurfing the MASH TsunamiSurfing the MASH TsunamiS5 - E20 - Lessons From EASL Congress 2024: Exciting Advances in Drug Development00:00:00 Surf's Up, Season 5 Episode 20Naim Alkhouri and Mazen Noureddin join co-hosts Jörn Schattenberg and Roger Green to discuss major drug development stories from the EASL Congress 2024. They pay tribute to Stephen Harrison and proceed to groundbreakers.00:08:16 - Presentations on ResmetiromMazen shares a paper he presented looking at resmetirom dose-response. The 100mg dose performed better than the 80mg dose. Jörn notes that the most important element of the study might be the demonstrated 36-month effect.  00:14:19- Implications of Different Analytical Modes Naim compares different modes of analysis. Intent to Treat, whi...2024-06-2057 minSurfing the MASH TsunamiSurfing the MASH TsunamiS5 - E16.1 - Remembering MASLD Master Stephen Harrison: Stephen As IntegratorThis conversation includes the first half of Jörn Schattenberg's and Roger Green's interview with Donna Cryer. While the question is about Stephen's most outstanding contribution to MASLD, the focus is more on his remarkable ability to trigger increased awareness of MASH in many different ways.Roger starts the conversation by asking Jörn and Donna to describe one outstanding contribution (okay, maybe two) that Stephen made to the field of MASLD. Jörn talks about Stephen's role as integrator, talking to all different kinds of players, designing trials, focusing on issues and needs of patients, regulators, inv...2024-05-2510 minThe Genetics PodcastThe Genetics PodcastEP 127: Insights into precision medicine, fatty liver disease, and minimally invasive diagnostic tools with Dr. Mazen Noureddin0:00 Intro0:25 Mazen’s lifelong commitment to furthering the field of precision medicine in liver disease research, fueled by a personal connection of his grandmother developing MASH cirrhosis2:30 Breakthroughs in the field of metabolic dysfunction-associated steatotic liver disease (MASLD) since the beginning of Mazen’s career5:30 The potential impact of Resmetirom, a new drug that could treat MASLD and MASH cirrhosis8:45 Significant takeaways from 40+ investigational clinical studies of novel treatments for MASLD/MASH 12:00 Alternatives to biopsies and potential tools for early, non-invasive diagnosis19:00 Genetic determinants and risk factors for fatty liver disease20:30 How Mazen uses...2024-03-2139 minCCO Medical Specialties PodcastCCO Medical Specialties PodcastThe Art of Multidisciplinary Care for Patients With Metabolic Dysfunction–Associated SteatohepatitisIn this episode, Arun B. Jesudian, MD, and Mazen Noureddin, MD, MHSc, discuss the expert-informed clinical pathway for the multidisciplinary care of patients with MASLD or MASH, current and emerging therapeutics, and management optimization strategies. Presenters:Arun B. Jesudian, MDAssociate Professor of Clinical MedicineDivision of Gastroenterology and HepatologyWeill Cornell MedicineNew York, New YorkMazen Noureddin, MD, MHScProfessor of MedicineHouston Methodist HospitalDirector Houston Research InstituteHouston, TexasContent based on an online CME program supported by in...2024-03-1329 minPCEPCEThe Art of Multidisciplinary Care for Patients With Metabolic Dysfunction–Associated SteatohepatitisIn this episode, Arun B. Jesudian, MD, and Mazen Noureddin, MD, MHSc, discuss the expert-informed clinical pathway for the multidisciplinary care of patients with MASLD or MASH, current and emerging therapeutics, and management optimization strategies. Presenters:Arun B. Jesudian, MDAssociate Professor of Clinical MedicineDivision of Gastroenterology and HepatologyWeill Cornell MedicineNew York, New YorkMazen Noureddin, MD, MHScProfessor of MedicineHouston Methodist HospitalDirector Houston Research InstituteHouston, TexasContent based on an online CME program supported by in...2024-03-1329 minSurfing the MASH TsunamiSurfing the MASH TsunamiS5 - E5.6 - From The Vault: Tsunami's First Look At MASEF, A Major New NITThis conversation comes from our first look at MASEF, last September, when lead author Mazen Noureddin joined the Surfers to discuss his recent breakthrough paper on this new NIT.  The original conversation had a robust write-up: Mazen Noureddin joins co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to discuss serum identification of at-risk MASH and the Metabolomics-Advanced Steatohepatitis Fibrosis Score (MASEF). In late July, Mazen co-authored a paper on the subject which was published in Hepatology.This conversation begins with Louise’s initial response around the setting of application for MASEF. She poses a ques...2024-03-1013 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E42.6 - From the Vault: NAFLD Summit in Context and Learning from Failed TrialsThis episode From the Vault comes from last year's SurfingNASH review of the 2022 NAFLD Summit with Mazen Noureddin, Sven Francque and Hannes Hagström.The 2022 NAFLD Summit uniquely presented a range of perspectives and insights on fatty liver and metabolic diseases.Program speakers Mazen Noureddin, Sven Francque and Hannes Hagström join Surfer, Roger Green, on site from Dublin to review their reactions immediately after the conference ended. At the outset of this episode, the group discusses the benefits of participating in a smaller conference more focused on the challenges presented by the field of NA...2023-10-0613 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E39.4 - MASEF: Where will we be in 2 years?Surfing NASH returns to its regular program with a fresh episode and some fascinating and progressive ideas around non-invasive testing. Mazen Noureddin joins co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to discuss serum identification of at-risk MASH and the Metabolomics-Advanced Steatohepatitis Fibrosis Score (MASEF). In late July, Mazen co-authored a paper on the subject which was published in Hepatology.This final conversation starts with Louise’s curiosity on whether any socioeconomic differences were clear between those considered at-risk. Mazen responds with his belief that there would be much to benefit from studying a larger prospective coh...2023-09-0309 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E39.3 - MASEF: Next Steps and New CohortsSurfing NASH returns to its regular program with a fresh episode and some fascinating and progressive ideas around non-invasive testing. Mazen Noureddin joins co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to discuss serum identification of at-risk MASH and the Metabolomics-Advanced Steatohepatitis Fibrosis Score (MASEF). In late July, Mazen co-authored a paper on the subject which was published in Hepatology.This conversation begins with Louise’s focus on pediatric cohorts and whether MASEF can be applied to younger populations. Mazen states that while it has yet to be applied in this way, he would be very int...2023-09-0310 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E39.2 - MASEF: Cost Effectiveness and Application SettingsSurfing NASH returns to its regular program with a fresh episode and some fascinating and progressive ideas around non-invasive testing. Mazen Noureddin joins co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to discuss serum identification of at-risk MASH and the Metabolomics-Advanced Steatohepatitis Fibrosis Score (MASEF). In late July, Mazen co-authored a paper on the subject which was published in Hepatology.This conversation begins with Louise’s initial response around the setting of application for MASEF. She poses a question that leads the group to explore possible pros and cons of different approaches and the potential impact eac...2023-09-0213 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E39.1 - MASEF: Study Parameters and Notable ResultsSurfing NASH returns to its regular program with a fresh episode and some fascinating and progressive ideas around non-invasive testing. Mazen Noureddin joins co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to discuss serum identification of at-risk MASH and the Metabolomics-Advanced Steatohepatitis Fibrosis Score (MASEF). In late July, Mazen co-authored a paper on the subject which was published in Hepatology.For this opening conversation, Mazen cogently introduces why and how MASEF came to exist as an emerging noninvasive test. He first notes the utility of the HbA1c test - one of the commonly used tests t...2023-09-0211 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E39 - The Metabolomics-Advanced Steatohepatitis Fibrosis Score (MASEF)This week, Surfing NASH returns to its regular program with a fresh episode and some fascinating and progressive ideas around non-invasive testing. Mazen Noureddin joins co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to discuss serum identification of at-risk MASH and the Metabolomics-Advanced Steatohepatitis Fibrosis Score (MASEF). Mazen co-authored a paper on the subject which was published in Hepatology as recent as late July. In a nutshell, this episode elucidates on developing and validating a highly specific metabolomics-driven score to identify at-risk MASH (metabolic dysfunction-associated steatohepatitis) patients. Ultimately, the paper concludes MASEF to indeed b...2023-08-3146 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E34.4 - Pemvidutide and the Importance of the Actual GLP-1-to-Glucagon Impact RatioThis month, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from June's two major conferences: the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. In doing so, the Big Band of Surfers (Stephen Harrison, Jörn Schattenberg, Louise Campbell and Roger Green) are joined by Mazen Noureddin for a fascinating conversation which covers compelling data and ideas emerging from the drug development space.This episode starts with a welcome (and happy birthday) to Roger as he belatedly joins the discussion. From here Mazen d...2023-07-3015 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E34.3 - The Increasing Importance of OmicsThis month, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from June's two major conferences: the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. In doing so, the Big Band of Surfers (Stephen Harrison, Jörn Schattenberg, Louise Campbell and Roger Green) are joined by Mazen Noureddin for a fascinating conversation which covers compelling data and ideas emerging from the drug development space.Mazen starts this conversation by stressing the importance of omics, particularly metabolomics and proteomics, in creating a single blood-based measure t...2023-07-2908 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E34.2 - Practical and Plausible Notes On Injectables Versus Oral AgentsThis month, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from June's two major conferences: the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. In doing so, the Big Band of Surfers (Stephen Harrison, Jörn Schattenberg, Louise Campbell and Roger Green) are joined by Mazen Noureddin for a fascinating conversation which covers compelling data and ideas emerging from the drug development space. Jörn and Mazen begin by prompting Stephen with questions around the FASCINATE-2 study outlined in the previous conversation. Stephen co...2023-07-2912 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E34 - Drug Development Stories from EASL and ADA: Part 2This month, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from June's two major conferences: the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This is the second session focusing on drug development, and specifically, on several presentations for exciting drugs in development.This session kicks off with a twist as co-host Jörn Schattenberg introduces the episode and its panelists because Roger Green is late (he will join later with a bit of birthday banter). Joining this in-depth discussion around the latest d...2023-07-271h 04Surfing the MASH TsunamiSurfing the MASH TsunamiS4-E31.4 - EASL Congress and ADA Scientific Sessions: Reshaping the way we think about Fatty Liver DiseaseThroughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy last few weeks at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This first installment comprises two distinct 1:1 interviews with Tsunami co-host Roger Green, one with key opinion leader Mazen Noureddin and the other with co-host Jörn Schattenberg.This final conversation between Roger and Jörn begins by moving beyond the subject of drugs to the importance behind noninvasive testing and the myriad ways by...2023-07-0916 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E31.3 - Jörn Schattenberg on the Therapeutic Landscape and Fibrosis ResolutionThroughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy last few weeks at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This first installment comprises two distinct 1:1 interviews with Tsunami co-host Roger Green, one with key opinion leader Mazen Noureddin and the other with co-host Jörn Schattenberg.This first conversation with Jörn starts with discussion around the idea that even dramatic improvements in obesity medications will not resolve all issues related to fi...2023-07-0913 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E31.2 - What do we know about mechanisms of action in NASH drugs and the commercial implications?Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy last few weeks at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This first installment comprises two distinct 1:1 interviews with Tsunami co-host Roger Green, one with key opinion leader Mazen Noureddin and the other with co-host Jörn Schattenberg.This second and final conversation with Mazen continues to explore what we do or do not know about the different mechanisms of action in NASH drugs an...2023-07-0913 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E31.1 - Mazen Noureddin on "NASH Monopoly"Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy last few weeks at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This first installment comprises two distinct 1:1 interviews with Tsunami co-host Roger Green, one with key opinion leader Mazen Noureddin and the other with co-host Jörn Schattenberg.This first conversation with Mazen begins with comments on the many excellent drug development studies emerging from both EASL Congress and the ADA's Scientific Sessions meeting. W...2023-07-0915 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E31 - Mazen Noureddin and Jörn Schattenberg on the Developing Therapeutic LandscapeThroughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy last few weeks at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego.   This first installment comprises two distinct 1:1 interviews with Tsunami co-host Roger Green, one with key opinion leader Mazen Noureddin and the other with co-host Jörn Schattenberg. The first conversation with Mazen begins with an illustrative new metaphor in which the NASH therapeutic landscape is likened to the game Monopoly. In "NASH...2023-07-0756 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E20.6 - From the Vault: Discussing NITs and Final Thoughts on NAFLD SummitThe 2022 NAFLD Summit presented a range of perspectives and insights on fatty liver and metabolic diseases. Program speakers Mazen Noureddin, Sven Francque and Hannes Hagström join Surfer, Roger Green, on site from Dublin to review their reactions immediately after the conference ended.This conversation From the Vault begins with Roger calling attention to a debate around NITs that took place on the opening day of the meeting. Mazen revisits what he has described on this podcast as the coming “combo-combo” world. The group generally agrees that biomarkers in primary care ought to be simple, cost effective and a...2023-05-1414 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E15.2 - Liver Forum 14: Panelists Select Sessions of InterestThis week on Surfing NASH, co-hosts Jörn Schattenberg and Roger Green review the recently concluded Liver Forum. Joining discussion are Liver Forum Executive Director Veronica Miller and speakers Mazen Noureddin (Houston Research Institute), Michelle Long (Novo Nordisk) and Jeff McIntyre (Global Liver Institute).Roger leads this conversation by asking the panelists to pick a particular session that captured their attention in a way that could not have been predicted. Michelle first mentions how the agenda as a whole illuminated the depth of the issues surrounding drug development for the fatty liver field. Veronica points t...2023-04-0811 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E15.1 - What is The Liver Forum and Initial ImpressionsThis week on Surfing NASH, co-hosts Jörn Schattenberg and Roger Green review the recently concluded Liver Forum. Joining discussion are Liver Forum Executive Director Veronica Miller and speakers Mazen Noureddin (Houston Research Institute), Michelle Long (Novo Nordisk) and Jeff McIntyre (Global Liver Institute). Veronica leads this conversation with a recap of how the Forum aims to advance the regulatory sciences for the treatment of NAFLD/NASH and liver fibrosis by providing an independent and neutral venue for multi-stakeholder dialogue. She underscores the importance of being able to convene as a community to discuss how drugs get researched and a...2023-04-0813 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E15 - Review of Liver Forum 14This week on Surfing NASH, co-hosts Jörn Schattenberg and Roger Green review the recently concluded Liver Forum. Joining discussion are Liver Forum Executive Director Veronica Miller and speakers Mazen Noureddin (Houston Research Institute), Michelle Long (Novo Nordisk) and Jeff McIntyre (Global Liver Institute). This integrative meeting aims to advance the regulatory sciences for the treatment of NAFLD/NASH and liver fibrosis by providing an independent and neutral venue for ongoing multi-stakeholder dialogue. The resulting conversations facilitate making the best science-based decisions on how to study efficacy and safety in real time as collective knowledge and experience w...2023-04-0653 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E13.3 - Discussing the Day 2 Program of INCBCN in BarcelonaSurfing NASH returns to preview the second Innovations in NAFLD Care Workshop (INCBCN) to be held in Barcelona from 26-27 May, 2023. Conference founders and directors Jeff Lazarus and Jörn Schattenberg discuss what makes the event unique with Louise Campbell and Roger Green. This conversation picks up with concluding comments around Day 1 in Barcelona. Jeff elaborates on a Patient Organisation session that closes with a roundtable discussion. For this discussion, Juan Mendive of the World Organization of Family Doctors will discuss primary care perspectives.Moving into Day 2, Jeff shares that friends of the podcast Alina Allen and M...2023-03-2510 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E13 - Previewing the 2023 Innovations in NAFLD Care WorkshopSurfing NASH returns to preview the second Innovations in NAFLD Care Workshop (INCBCN) to be held in Barcelona from 26-27 May, 2023. Conference founders and directors Jeff Lazarus and Jörn Schattenberg discuss what makes the event unique with Louise Campbell and Roger Green.From the outset, Jeff underscores that this meeting fills an important gap between the heavy-hitting conferences in NAFLD and NASH. The INCBCN Workshop exists to explore dynamic and nuanced insights into both liver disease and holistic liver health in a smaller, more multidisciplinary forum. He recaps receiving positive feedback and building a follow-up program f...2023-03-2344 minSurfing the MASH TsunamiSurfing the MASH TsunamiS4-E3.2 - NASH-TAG Review: NITs, Clinical Trial Design and Addressing “Indeterminate Zones”NASH-TAG 2023 proved to be a watershed moment for Fatty Liver disease as exciting drug development readouts, powerful academic work on non-invasive tests and the willingness to dive into the toughest questions aligned in Deer Valley, Utah. In this weekend’s conversation series, Surfing NASH reviews its diverse coverage of the conference by showcasing key excerpts across six recordings with various KOLs, patient advocates and stakeholders.This conversation featuring Stephen Harrison, Mazen Noureddin and Jörn Schattenberg begins with Mazen describing how exciting and informative the new sessions on non-invasive tests were. Specifically, he details his own surprise at...2023-01-1418 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E62.1 - Year-End Interview with Mazen NoureddinIn the Season 3 NAFLD Year-in-Review conversations series, Surfers Jörn Schattenberg, Louise Campbell and Roger Green embark on a string of interviews with a handful of Key Opinion Leaders who made headlines and advances in Fatty Liver disease in 2022. In this exclusive segment, Mazen Noureddin reflects on both personal and professional developments. Mazen begins by describing a move from Los Angeles to Houston where he is focused on establishing the state-of-the-art Houston Research Institute. He next highlights contributing to the development of a highly specific MRI-based (MAST) score to identify patients with fibrotic NASH as a major ac...2022-12-2830 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E60.5 - Madrigal Announcement on Resmetirom: Combination Therapy and Closing TakeawaysIn a monumental moment in the never-ending pursuit of putting a major dent in Fatty Liver disease, Madrigal Pharmaceuticals announced positive topline results from the pivotal Phase 3 MAESTRO-NASH clinical trial of resmetirom for the treatment of NASH and liver fibrosis. Madrigal’s leadership intends to file for resmetirom’s accelerated approval with the FDA in the first half of 2023. If approved, the drug may become the first NASH medication introduced to market, depending on the outcome and timing of Intercept Pharmaceuticals’ refiling of obeticholic acid.To recognize this special occasion, Surfing the NASH Tsunami hosts its largest ever s...2022-12-2619 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E60.4 - Madrigal Announcement on Resmetirom: Basic Science and Impact on Future Use of NITsIn a monumental moment in the never-ending pursuit of putting a major dent in Fatty Liver disease, Madrigal Pharmaceuticals announced positive topline results from the pivotal Phase 3 MAESTRO-NASH clinical trial of resmetirom for the treatment of NASH and liver fibrosis. Madrigal’s leadership intends to file for resmetirom’s accelerated approval with the FDA in the first half of 2023. If approved, the drug may become the first NASH medication introduced to market, depending on the outcome and timing of Intercept Pharmaceuticals’ refiling of obeticholic acid.To recognize this special occasion, Surfing the NASH Tsunami hosts its largest ever s...2022-12-2615 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E60.3 - Madrigal Announcement on Resmetirom: Diving into ImplicationsIn a monumental moment in the never-ending pursuit of putting a major dent in Fatty Liver disease, Madrigal Pharmaceuticals announced positive topline results from the pivotal Phase 3 MAESTRO-NASH clinical trial of resmetirom for the treatment of NASH and liver fibrosis. Madrigal’s leadership intends to file for resmetirom’s accelerated approval with the FDA in the first half of 2023. If approved, the drug may become the first NASH medication introduced to market, depending on the outcome and timing of Intercept Pharmaceuticals’ refiling of obeticholic acid.To recognize this special occasion, Surfing the NASH Tsunami hosts its largest ever s...2022-12-2415 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E60.2 - Madrigal Announcement on Resmetirom: First Reactions and Differing PerspectivesIn a monumental moment in the never-ending pursuit of putting a major dent in Fatty Liver disease, Madrigal Pharmaceuticals announced positive topline results from the pivotal Phase 3 MAESTRO-NASH clinical trial of resmetirom for the treatment of NASH and liver fibrosis. Madrigal’s leadership intends to file for resmetirom’s accelerated approval with the FDA in the first half of 2023. If approved, the drug may become the first NASH medication introduced to market, depending on the outcome and timing of Intercept Pharmaceuticals’ refiling of obeticholic acid.To recognize this special occasion, Surfing the NASH Tsunami hosts its largest ever s...2022-12-2415 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E54.1 - Utilizing Best Practices in DiagnosticsSven Francque begins this conversation by discussing Laurent Castera’s paper comparing a range of NIT diagnostic tests: MAST, FAST, MEFIB, FIB-4 and NFS. When introducing the paper, Sven shares two items that Mazen Noureddin did not cover in an earlier preview. Professor Castera and his team used fairly low ALT cutoffs of 20 for women and 30 for men as the sole liver entry criterion for the study. The implication of this was to produce a relatively unbiased population sample in which more than 50% of patients exhibited NASH. Stephen Harrison joins to share data from his presentation on the FASN in...2022-11-1313 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E52.4 - Exploring the NAFLD-Metabolic Link Through Screening ToolsIn a follow-up preview, Jörn Schattenberg, Louise Campbell, Mazen Noureddin, Ian Rowe and patient advocate Jeff McIntyre join Roger Green to discuss key presentations and posters of interest at the 73rd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD). On November 4th-8th in Washington DC, as many as 10,000 attendees will convene in an effort to advance and disseminate the science and practice of hepatology, and to promote liver health and quality patient care. Continuing from the previous conversation, Roger starts by questioning what the right long-term commercial model for remote p...2022-11-0612 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E52.2 - Efficacy of NITs and Predictive OutcomesIn a follow-up preview, Jörn Schattenberg, Louise Campbell, Mazen Noureddin, Ian Rowe and patient advocate Jeff McIntyre join Roger Green to discuss key presentations and posters of interest at the 73rd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD). On November 4th-8th in Washington DC, as many as 10,000 attendees will convene in an effort to advance and disseminate the science and practice of hepatology, and to promote liver health and quality patient care.Louise leads this conversation with commentary carrying over from last week’s discussion on FibroScan as an ess...2022-11-0512 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E52.1 - FIB-4 and the Way Forward in Primary Care ScreeningIn a follow-up preview, Jörn Schattenberg, Louise Campbell, Mazen Noureddin, Ian Rowe and patient advocate Jeff McIntyre join Roger Green to discuss key presentations and posters of interest at the 73rd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD). On November 4th-8th in Washington DC, as many as 10,000 attendees will convene in an effort to advance and disseminate the science and practice of hepatology, and to promote liver health and quality patient care.This conversation focuses on a presentation by Laurent Castera from Parallel Session 33 on Monday afternoon. The abstract l...2022-11-0512 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E52 - Part 2: A Preview of the 2022 AASLD Liver MeetingIn a follow-up preview, Jörn Schattenberg, Louise Campbell, Mazen Noureddin, Ian Rowe and patient advocate Jeff McIntyre join Roger Green to discuss key presentations and posters of interest at the 73rd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD). On November 4th-8th in Washington DC, as many as 10,000 attendees will convene in an effort to advance and disseminate the science and practice of hepatology, and to promote liver health and quality patient care.Mazen begins by highlighting a presentation by Laurent Castera which covers an abstract the two collaborated on. T...2022-11-0356 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E48.3 - More Positive Phase 2B Results from PoxelA recent string of press releases presaged some of the most exciting, promising data of the last decade in NASH drug development. In this conversation, Stephen Harrison continues his review of Phase 2B results from Akero’s HARMONY Trial before introducing more positive Phase 2B results from a study by Poxel. Mazen Noureddin, Jörn Schattenberg, Louise Campbell and Roger Green share impressions.  Mazen asked whether the future must rely on combination therapies. The question leads Roger back to a comment Akero Chief Development Officer, Kitty Yale, made in a January 2021 podcast. She stated that Akero believes the...2022-10-0813 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E48.2 - Phase 2B 'Wow!' Results from Akero’s HARMONY TrialA recent string of press releases presaged some of the most exciting, promising data of the last decade in NASH drug development. In this conversation, Principal Investigator Stephen Harrison reviews Phase 2b results from Akero’s HARMONY Trial. Special guest Mazen Noureddin joins Jörn Schattenberg, Louise Campbell and Roger Green to share impressions. This conversation starts with Stephen returning to his discussion of Altimmune’s dual GLP-1/glucagon agonist, pemvidutide. He comments that stock analysts appear to have punished Altimmune because pemvidutide did not demonstrate greater weight loss. He considers this an inaccurate read. He notes that t...2022-10-0814 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E48 - Review of Exciting Clinical Trial Press ReleasesA recent string of press releases has presaged some of the most exciting, promising data of the last decade in NASH drug development. In this episode,  Stephen Harrison reviews recent press releases from Altimmune, Akero, Poxel, Axcella and Intercept, while Jörn Schattenberg, Louise Campbell, special guest Mazen Noureddin and Roger Green share questions and impressions. Last month, Altimmune presented its top-line results of a 12 week Phase 1B study of pemvidutide, a GLP-1/glucagon dual receptor agonist. After outlining the study design, Stephen summarizes the positive results of liver fat content reduction. Jörn takes interest in exte...2022-10-0659 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E47.4 - Potential Bottlenecks in Getting Drugs to NAFLD PatientsAfter a month of major Fatty Liver medical meetings, Jörn Schattenberg, Louise Campbell and Roger Green explore emerging stories that will shape the next 6-12 months in Fatty Liver disease. This conversation speculates where potential bottlenecks in getting drugs to patients might emerge.Louise points to payers as a significant barrier en route to product adoption. Roger suggests it depends on the healthcare system, but generally agrees with Louise. He references the past development of a Hep C treatment for a comparable example. Payers slowed adoption of drugs with clear long-term benefits due to the short-term c...2022-10-0212 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E46.5 - Discussing NITs and Final Thoughts on NAFLD SummitThe 2022 NAFLD Summit presented a range of perspectives and insights on fatty liver and metabolic diseases. Program speakers Mazen Noureddin, Sven Francque and Hannes Hagström join Surfer, Roger Green, on site from Dublin to review their reactions immediately after the conference ended. This final conversation begins with Roger calling attention to a debate around NITs that took place on the opening day of the meeting. Mazen revisits what he has described on this podcast as the coming “combo-combo” world. The group generally agrees that biomarkers in primary care ought to be simple, cost effective and accessible. However, Sven utter...2022-09-2516 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E46.4 - Weight Change and Lifestyle Modification in Clinical TrialsThe 2022 NAFLD Summit presented a range of perspectives and insights on fatty liver and metabolic diseases. Program speakers Mazen Noureddin, Sven Francque and Hannes Hagström join Roger Green on-site from Dublin to review their reactions immediately after the conference ended. In this conversation, the panelists examine the impact of weight change and lifestyle modification in clinical trials while utilizing insights from the bariatric and diabetes fields.This conversation continues the issue of Hawthorne effects in trial design. Hannes starts by noting we can learn from obesity trials – and also from TV shows like “Biggest Loser” – that people re...2022-09-2506 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3 E46.3 - Discussing Clinical Trial Design at the NAFLD SummitThe 2022 NAFLD Summit presented a range of perspectives and insights on fatty liver and metabolic diseases. In this conversation, the panelists explore issues around clinical trial design, focusing specifically on the value of Phases 2a and 2b and whether improvement in patient self-management during trials is a research artifact or a replication of reality. This conversation addresses two issues in clinical trial design. First, Roger Green draws on the Session 9 discussion of failed trials to ask which is the right way to proceed when a drug in a Phase 2b trial fails to reach its...2022-09-2410 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E46.2 - NAFLD Summit in Context and Learning from Failed TrialsThe 2022 NAFLD Summit uniquely presented a range of perspectives and insights on fatty liver and metabolic diseases. Program speakers Mazen Noureddin, Sven Francque and Hannes Hagström join Surfer, Roger Green, on-site from Dublin to review their reactions immediately after the conference ended. At the outset of this episode, the group discusses the benefits of participating in a smaller conference more focused on the challenges presented by the field of NAFLD. Mazen likens the NAFLD Summit to NASH-TAG, asserting that these specific conferences advance the field and address deeper layers around the issues that matter most....2022-09-2412 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E46.1 - Underreported Alcohol Use and Treating ComorbiditiesThe 2022 NAFLD Summit presented a range of perspectives and insights on fatty liver and metabolic diseases. Program speakers Mazen Noureddin, Sven Francque and Hannes Hagström join Surfer Roger Green, on-site from Dublin to review their reactions immediately after the conference ended. In this episode, the panelists discuss presentations and sessions they found particularly compelling. The group notes Session 7 from Day 2 as an attractive line of topics covering overlooked issues in clinical trials. While difficult to quantify the impact on clinical trials, the data supports approximately 10% of patients with NAFLD underreport alcohol consumption. Hannes’ own presentation at the...2022-09-2412 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E46 - A Review of the 2022 NAFLD Summit from DublinThe 2022 NAFLD Summit presented a range of perspectives and insights on fatty liver and metabolic diseases. In this episode, program speakers Mazen Noureddin, Sven Francque and Hannes Hagström join Surfer, Roger Green, on site from Dublin to review their thoughts and key takeaways immediately after the conference ended. Roger starts by asking each to choose and elaborate on one presentation or session of particular interest. Hannes is the first responder, establishing Session 7 from Day 2 as an attractive line of topic covering overlooked issues in clinical trials. While difficult to quantify the impact on clinical trials, the data supports a...2022-09-2255 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E43 - Combination Agents: a Cornerstone Of Future NASH Therapy?This episode explores the future of combination agents in NASH Therapy. First author Naim Alkhouri and last author Mazen Noureddin join the Surfers to discuss their recently published article, Safety and efficacy of combination therapy with semaglutide, cilofexor and firsocostat in patients with non-alcoholic steatohepatitis: A randomised, open-label phase II trial (JHEP, 2022). While the conversation starts by focusing on this article, the discussion itself takes a far broader look at the strategies behind developing combination agents, the likely role these combination therapies will play in treating patients, and, more generally, what Mazen Noureddin describes as the coming “combo-combo” world.2022-09-011h 03Surfing the MASH TsunamiSurfing the MASH TsunamiS3-E40.5 - From the Vault: Why Cirrhosis Matters In Clinical Trial StrategyEpisode 40 focuses on lean NASH, and Michelle Long notes that many patients with lean NASH are diagnosed in the Emergency Department when they present with symptoms of decompensating cirrhosis. This conversation from November 2021 considers cirrhotic patients from a different perspective: their uniquely valuable role in clinical trial strategy as the world evolves beyond biopsy as gold standard.Mazen Noureddin notes during this week's episode that when he identifies lean NASH patients, he encourages them strongly to participate in clinical trials. This conversation also looks at the value of cirrhosis studies in clinical trial design, although from a...2022-08-1454 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E40.4 - Challenges of Alcohol Screening in Fatty Liver DiseaseAs the NASH pandemic grows in the number and diversity of patient cases, one patient group receiving increased notice includes patients with "lean NASH," those with "normal" BMI levels (BMI2022-08-1413 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E40.3 - Importance of Early Diagnosis in Lean NASHAs the NASH pandemic grows in the number and diversity of patient cases, one patient group receiving increased notice includes patients with "lean NASH," those with "normal" BMI levels (BMI2022-08-1412 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E40.2 - A Simple Diagnostic Algorithm for Lean NASHAs the NASH pandemic grows in the number and diversity of patient cases, one patient group receiving increased notice includes patients with "lean NASH," those with "normal" BMI levels (BMI2022-08-1313 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E40.1 - Best Practices in Lean NASH: How the Article Came AboutAs the NASH pandemic grows in the number and diversity of patient cases, one patient group receiving increased notice includes patients with "lean NASH," those with "normal" BMI levels (BMI2022-08-1312 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E40 - Best Practices in Lean NASH -- Authors Provide Back StoryAs the NASH pandemic grows in the number and diversity of patient cases, one patient group receiving increased notice includes patients with "lean NASH," those whose BMI levels are "normal." Last month, Gastroenterology published Best Practice recommendations for diagnosing and treating lean NASH. Two of the authors, Drs. Michelle Long and Mazen Noureddin, were good enough to come on the podcast to share the thinking behind this article along with its key observations and recommendations.This conversation starts with Roger Green asking Michelle and Mazen how they came to write this piece and how the paper came...2022-08-1152 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E38.5 - From the Vault: NAIL-NIT tackles NAS Score ChallengesOur week of "Greatest Hits" episodes from the vault continues with this conversation from the episode announcing the launch of the NAIL-NIT consortium. Stephen Harrison and Mazen Noureddin discuss the thinking behind their new consortium and its targets. In this conversation, they discuss challenges with the NAS score.The early part of 2022 had several episodes discussing the increasing need to move beyond biopsy (yes, semi-quantitative, but even AI-assisted at some levels) to a future shaped by NITs. One pivotal issue that emerged regarded ballooned hepatocyte evaluation and its impact on NAS scores. As I wrote: T...2022-07-3016 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E34.2 - #ILC2022 Looking Back: Other Thoughts on Resmetirom PresentationsLast week, roughly 5,000 liver community stakeholders gathered in London for the 2022 International Liver Congress (#ILC2022,) the first major hepatology Congress to be held in person since the start of the pandemic (smaller, but very valuable, meetings like NASH-TAG, LiverCONNECT and Paris NASH have taken place with an in-person component, but the International Liver Congress and The Liver Meeting have not). On the last full day of the program, several vitally important drug development studies were presented during the late-breaker and dedicated sessions. The conversations in this episode will review some of the most important findings. This particular conversation includes...2022-07-0211 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E33 - Day 4 of ILC2022: Friendly Debates About NITs, PLUS Discussing the Patient Advocate's PerspectiveThe International Liver Congress (#ILC2022) is the first major hepatology Congress to be held in person since the start of the pandemic (smaller, but very valuable, meetings like NASH-TAG, LiverCONNECT and Paris NASH have taken place with an in-person component, but the International Liver Congress and The Liver Meeting have not).The conversation takes place against the schedule of a live Congress on the day that focused on drug development. This presented scheduling challenges, which Louise Campbell addressed by combining two shorter conversations.The first conversation included Jörn Schattenberg, Mazen Noureddin and Ian Rowe a...2022-06-2850 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E25.5 - Emerging Concepts in NASH: Fatty Liver Pathophysiology, Epidemiology, Co-MorbiditiesThis conversation is centered on Mazen Noureddin's portion of Madrigal's disease-focused presentation at the Chronic Liver Disease Foundation's LiverConnect meeting this past March in Scottsdale, AZ. Mazen addresses issues of NAFLD Pathophysiology and NASH epidemiology, after which he answers questions and reviews key elements of the presentation with Roger Green.This episode and all its conversations are sponsored by Madrigal Pharmaceuticals. Conversations 25.5 and 25.6 are a two-part summary of Madrigal's disease-focused presentation at the recent CLDF LiverConnect meeting.2022-05-2221 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E19.3 - NAIL-NIT: What Naim Alkhouri and Jörn Schattenberg Plan for Retrospective AnalysisThis conversation starts with Naim Alkhouri and Jörn Schattenberg defining the wealth of data resources and hypotheses they are bringing to their roles as co-leads of retrospective analysis for NAIL-NIT. Mazen Noureddin then asks each of them to describe his "passionate first project." This leads Naim to discuss drug evaluation principles he finds so counterproductive that they fit into Nassim Taleb's definition of "IYI" ("Intellectual Yet Idiot"). As the discussion ends, Roger Green ties this issue to the analytical fallacy of quantifying a soft qualitative measure for drug evaluation purposes and Mazen points out that we will need t...2022-04-1612 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3 - E19.2 - Beginnings And Core Principles In The Move Beyond the BiopsyIn this brief conversation, Stephen Harrison discusses the exciting goal and ambitious research plan for NAIL-NIT, after which Mazen Noureddin describes the patient-focused issues and conference conversations that motivated Stephen and Mazen to form and recruit members for this consortium. It is a short but rich listen that will help you understand exactly what NAIL-NIT is driving to accomplish. This week marks the 2nd anniversary of Surfing the NASH Tsunami! Thank you for being part of the process that has brought us this far: 126 episodes and 335 separate podcast postings and over 58,000 downloads by individuals in over 105 different c...2022-04-1610 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E16.5 - Ready for "Prime Time?" - MRE and Hepatogram in NASH Clinical PracticeThe conversation was originally recorded on January 27, 2022. It focuses on use of MR Elastography to diagnose, treat and monitor NASH patients in an outpatient setting through two uses of MRE -- the MAST test, which includes MRE, MRI-PDFF and AST and the basic Hepatogram test, which includes MRE and MRI-PDFF, or, as Mazen Noureddin describes it during the conversation, MREFF.This conversation is too long and detailed for a typical section-by-section synopsis, so this write-up will summarize the major elements. After introductions and icebreakers, Mazen Noureddin starts the conversation by discussing MAST and how he came to...2022-03-2748 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E14.5 - Improving Ballooned Hepatocyte Analysis Through Artificial IntelligenceThe episode and this conversation is sponsored by HistoIndex. This specific conversation focuses on ways and AI-assistive technologies and analyses can improve our abilities to assess efficacy in drugs that treat advanced fibrosis and cirrhosis.For this extrasode, HistoIndex Chief Scientific Officer Dean Tai joins Quentin Anstee, Mazen Noureddin, Joern Schattenberg and Roger Green to discuss how AI-based algorithms can support improved analysis of ballooned hepatocyte changes both in advanced fibrosis and cirrhosis patients.The rest of the conversation probes how this work will affect diagnosis and drug development, what other tests panelists can foresee...2022-03-1442 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E14 - NAS Scores and the Challenge of Complex Ballooned HepatocytesOne major discussion at NASH-TAG this year was about the inconsistency in ballooned hepatocyte identification and how this inconsistency inflates screen fail rates and possibly placebo response across studies. This episode explores that issue in detail.The episode is sponsored by HistoIndex. At the back of the episode is a discussion of how artificial intelligence driven assistive technology can improve the consistency of ballooned hepatocyte scoring in advanced fibrosis and support development of robust outcomes for fibrosis studies.This conversation includes three of the paper's authors, including last author Quentin Anstee. The conversation starts with...2022-03-101h 34Surfing the MASH TsunamiSurfing the MASH TsunamiS3-E11.3 - NAIL-NIT and the Challenges of the NAS ScoreThe conversation looks at how the NAIL-NIT program design improves on the quality of insight provided by the NAS score, both in terms of drug development and treatment of individual patients. Also, note that during this conversation, Mazen Noureddin thanks a relatively large group of individuals and companies supporting this project. The first section focuses mostly on what we can and cannot learn from a NAS score, and implications of its shortcomings on the drug development process. After this, Stephen Harrison notes the complex role the liver plays in energy transfer throughout the entire metabolic process. This s...2022-02-2012 minSurfing the MASH TsunamiSurfing the MASH TsunamiS3-E11.1 - NAIL-NIT: The Thinking Behind a New NAFLD ConsortiumNAIL-NIT is a new NAFLD consortium dedicated to exploring the direct relationship between non-invasive testing (NITs) and outcomes in Fatty Liver disease. In this opening conversation, study co-directors Stephen Harrison and Mazen Noureddin are joined by Steering Committee members Amy Articolo, Medical Director for NASH at Novo Nordisk and Senthil Sundaram, CEO of Terns Pharmaceuticals. One at a time, the four panelists describe their motivations for forming and becoming a part of this consortium. Mazen Noureddin talks about the group's common goal to produce data that will shape a shift from biopsy-derived drug approval analyses to NITs. S...2022-02-1915 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E62.1 - SurfingNASH's 2021 NAFLD year-in-review Covers AI in HistopathologyThis conversation is part of SurfingNASH's 2021 NAFLD Year-In-Review. Dr. Mazen Noureddin, Director of the Fatty Liver Program at Cedars Sinai, Los Angeles, joins Louise Campbell and Roger Green to discuss advances in AI in histopathology.Mazen Noureddin notes that while non-invasive tests are important and likely to become more so over time, drug development today will need to rely on AI to interpret and ultimately improve histology reads. One benefit he notes is the ability of AI reads to reveal differences between cirrhosis patients in terms of percentage of liver that is F4 vs. F3. In one...2021-12-2332 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E62 - Mazen Noureddin, Alina Allen And Wayne Eskridge Join SurfingNASH's 2021 NAFLD Year-in-ReviewThe last half of December marks our annual NAFLD Year-in-Review. Episodes 62-64 each include ~20 minute segments of longer interviews with Stakeholders who have made a dent in Fatty Liver disease in 2021. In this episode, Louise Campbell and Roger Green are joined by Mazen Noureddin,  Alina Allen, Wayne Eskridge.Highlights: 7:51 – Mazen Noureddin begins talking about AI and histopathology by pointing to recent review papers listeners should read, one from Mayo Clinic and another from Mazen and colleagues. 8:21 – AI tools: machine learning and deep learning. Key AI targets: non-invasive testing and histology. More recent progress in histology.10...2021-12-2357 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E58.2 - Focus On NASH Cirrhosis: Reviewing FALCON 2 and the Belapectin Post Hoc Analysis of Phase 2 DataThis episode follows S2 E43 in discussing the possible role of NASH cirrhosis clinical trials in the transition from biopsy as gold standard to a post-biopsy world. Stephen Harrison starts this conversation by reviewing a post hoc analysis of Phase 2 belapectin data from Galectin Therapeutics, followed by a review of the FALCON 2 stud of pegbelfermin in NASH cirrhosis, sponsored by Bristol Myers Squibb. Jörn Schattenberg, Mazen Noureddin and Roger Green add their perspectives to the conversation.Stephen's primary point from the belapectin post hoc analysis is a practical one: the high correlation between an A...2021-11-2716 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E58.1 - Focus On NASH Cirrhosis: Why Cirrhosis Matters and Review of REVERSE Results at AASLDThis episode follows S2 E43 in discussing the possible role of NASH cirrhosis clinical trials in the transition from biopsy as gold standard to a post-biopsy world. Stephen Harrison starts this conversation by discussing why we focus on NASH cirrhosis and goes on to review the recent presentation of results from the REVERSE study on obeticholic acid. Jörn Schattenberg and Mazen Noureddin add their perspectives to the conversation.In this conversation, Stephen starts by pointing out that non-cirrhotic NASH trials and NASH cirrhosis trials differ significantly in goals, endpoints and patient severity. From there, h...2021-11-2714 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E56 - Day Four at the 2021 TLMdX From AASLDDrs. Michael Charlton and Mazen Noureddin and Global Liver Institute Director of Global NASH Programs Jeff McIntyre join Dr. Stephen Harrison, Louise Campbell and Roger Green to review some of the most important and exciting presentations from the final two days of the 2021 TLMdX, the annual meeting of AASLD. Each panelist chose 1-2 presentations or posters from the 2021 TLMdX from AASLD that they thought conveyed a major topic or question in the meeting. The group discussed each paper, sometimes moving far afield the original topic. As usual with SurfingNASH, conversations were interspersed with challenging insights and comments, d...2021-11-161h 50Surfing the MASH TsunamiSurfing the MASH TsunamiS2-E48.3 - Closing thoughts on Summer: Looking From a Patient-Based PerspectiveMazen Noureddin joins Stephen Harrison, Louise Campbell and Roger Green to close our series of "Biggest Stories of NASH Summer." In this conversation, Louise Campbell raises two very different points about the earlier conversation.Louise's first point has to do with steps taken to maintain compliance with clinical trials and whether researchers can analyze these in a way that will help front-line treaters understand what are keys to patient pharmaco-adherence. This leads to a conversation about why trials are managed the way they are and what it is reasonable to expect from front-line practices. Louise's...2021-10-0313 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E48.2 - Closing Thoughts On Summer: More on FGF-21s and A Topical "Hijacking"Mazen Noureddin joins Stephen Harrison, Louise Campbell and Roger Green to close our series of "Biggest Stories of NASH Summer." In this conversation, Stephen Harrison starts by discussing some issues and insights around the use of FGF-21s and then "hijacks" the conversation to explore a standard practice in histopathology that he would like to change.This conversation starts with Stephen talking about the differences between FGF-21s and discussing why these results are so compelling. He asks Mazen to comment on how he expects to use FGF-21s in practice and Mazen provides a...2021-10-0212 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E48.1 - Closing Thoughts On Summer: Mazen Noureddin's Two Big ThingsMazen Noureddin joins Stephen Harrison, Louise Campbell and Roger Green to close our series of "Biggest Stories of NASH Summer." In this conversation, Stephen Harrison provides an image to suggest the enormity of the coming NASH pandemic and Mazen identifies his two biggest stories of summer.Mazen's "biggest things of summer" include Stephen's recent article on the efruxifermin Phase 2a trial that was published in Nature and the Mayo Clinic group's work on MRE. For the efruxifermin, he cites some remarkably positive trial results, with a second related point. The study was published in Nature...2021-10-0211 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E48 - Closing Thoughts On an Eventful NASH SummerMazen Noureddin joins Stephen Harrison, Louise Campbell and Roger Green to close our series of "Biggest Stories of NASH Summer" with his own unique slant on recent events and publications.Mazen's take on the 'Biggest Stories of NASH Summer" integrates the content of papers, the journals in which they were published and the attention they received to form a message that says, "Fatty Liver has more good news to report and more people who want to learn about it." Halfway through, Stephen Harrison "hijacks" the episode to ask a common sense question about how the...2021-09-3050 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E26.3 - How much will real-life NASH treatment decisions depend on the specialty of the prescriber?azen Noureddin returns to discuss the roles different drugs and drug classes will play in NASH therapy after current Phase 2b and Phase 3 candidates have been approved. This conversation considers how the idea that front-line treaters will be PCPs might affect treatment patterns. This conversation starts with Roger Green pointing out that most real-world patient treatment decisions will be made by front-line, primary care physicians. Stephen Harrison proposes one more application for the "KISS" rule and talks about the role of EHRs in driving long-term guideline development and adherence. Mazen Noureddin considers how order of...2021-05-2318 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E26.1 - What will NASH Pharmacotherapy Look Like When we have Multiple Options?Mazen Noureddin returns to discuss the roles different drugs and drug classes will play in NASH therpy after current Phase 2b and Phase 3 candidates have been approved. This conversation lays out basic premises. In this conversation, Stephen Harrison and Mazen focus on how treatment guidelines and therapeutic choices might vary for patients starting at F2 vs. F3 vs. compensated (maybe even decompensated?) cirrhosis. One key issue is "de-escalation" -- whether guidelines will suggest treating with agents that are more potent injectible anti-fibrotics for later stage patients, then retreating to orals with broader metabolic effects when p...2021-05-2212 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E26 - What Will Treatment Pathways Look Like For NASH Patients?Mazen Noureddin joins the Surfers to explore the issues and needs that will shape treatment guidelines in a world after NASH drugs come to market.In Season 2 Episode 16, a discussion of cost-effectiveness led to the question, "How will treatment pathways and rules evolve as new NASH drugs come to market." Mazen Noureddin, who raised this issue with Stephen Harrison in the earlier episode, returns to explore the answer ten episodes later.The discussion considers what the phrase "backbone therapy" will mean in the future of NASH therapy and which agent(s) might attain...2021-05-2050 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E16.3 - How NASH treatment Might Evolve as Therapies Come to MarketThe final conversation of Episode 16 explores possible possible pathways and treatment strategies for NASH therapy in a future world with multiple classes of agents. In different ways, Mazen Noureddin and each Surfer discuss how cost-effective patient treatment might actually provide the right medicine for the right patient all along the therapeutic path. What makes NASH a little different from other diseases? Because the liver can heal itself, doctors will need to manage drug use during the disease regression process if all goes well. This is a different way of thinking, driven in part by the...2021-03-2816 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2 E16.1 -- How Cost-Effectiveness Research On Widespread NIT Screening In The U.S. Has EvolvedMazen Noureddin describes how he became engaged in studying the cost-effectiveness of widespread NASH screening for diabetics in the US, and what he has found, while the Surfers comment on the value of this pivotal work. After Mazen discusses how he became engaged in studying cost effectiveness in screening diabetes patients for  NASH, he offers a 30,000-foot view of his findings and shares thoughts on what he plans to study next. Stephen Harrison and Louise Campbell comment on the exceptional value of his work, after which Roger Green joins Louise in asking how COVID-19 might shape fu...2021-03-2717 minSurfing the MASH TsunamiSurfing the MASH TsunamiS2-E16 -- Cost-Effectiveness of Widespread Non-Invasive NASH Testing and TreatmentMazen Noureddin joins the Surfers to discuss his work determining cost effectiveness of Non-Invasive Testing in Type 2 diabetics and the broader population. The discussion shifts to considering broader treatment issues. Dr. Noureddin starts the discussion by providing a history of cost-effectiveness research in NASH and NAFLD. At a population level, biopsy turns out never to be cost-effective while less expensive tests almost always are. As the group brainstormed implications and new questions, they touched on theories on how cost-effectiveness for F3 and F2 patients might differ, and even how chronic therapies and sequential use of specific m...2021-03-2554 min