MENA Expert Panel Recommends Resmetirom and Semaglutide Protocols for MAFLD/MASH Patients

Metabolic dysfunction-associated fatty liver disease (MAFLD), including its progressive form MASH (metabolic-associated steatohepatitis), affects up to 40% of the population in the Middle East and North Africa (MENA) region. This condition is a leading cause of cirrhosis and hepatocellular carcinoma, often necessitating liver transplantation. Historically, no specific pharmacotherapies existed for MAFLD or MASH, leaving a significant therapeutic gap. The recent FDA conditional approvals of resmetirom and semaglutide for non-cirrhotic moderate-to-advanced (fibrosis stages 2 or 3) MASH represent a critical advancement, providing the first targeted treatment options.

An expert panel from the MENA region conducted a comprehensive literature review to formulate regional recommendations for resmetirom and semaglutide in MAFLD management. They systematically searched PubMed and Google Scholar, focusing on existing clinical trials and international guidelines relevant to these two agents. The panel's objective was to identify the target treatment population, propose criteria for therapy cessation, outline monitoring protocols, and address specific regional knowledge gaps concerning the implementation of these novel therapies for MASH.

The expert panel established key recommendations for the use of resmetirom and semaglutide in the MENA region, specifically targeting patients with non-cirrhotic moderate-to-advanced MASH (defined as fibrosis stages 2 or 3). They identified the appropriate patient population who would benefit most from these interventions, aligning with the recent FDA approvals. Furthermore, the panel proposed specific criteria for the cessation of therapy, although the abstract does not detail these criteria. Comprehensive monitoring protocols were outlined to ensure both the safety and efficacy of treatment for patients receiving resmetirom or semaglutide.

The panel underscored that the approval of the first two drugs for MASH marks a significant milestone in addressing this previously untreatable condition, emphasizing the transformative potential for patient care. They also highlighted critical regional challenges, including issues of access and affordability, which are deemed crucial determinants of the actual adoption and widespread use of these therapies across the MENA region.