At one extreme, many chronic therapies have a single monotherapy backbone agent, like what metformin has been to Type 2 diabetes. At the other, there are diseases where prescribers start with multiple different agents, or even different modes of action. The Surfers explore what is likely to happen in the future of NASH: one backbone vs. one for F4 and others for earlier stages vs. the idea that different patients’ metabolic issues might suggest different starting points. Louise Campbell goes so far as to ask whether diet and exercise not only should be the starting point but whether it should be taken seriously as a discrete line of therapy. This is an interesting window into our treatment future.

TOPICS: Diabetes, DrugTrial, Elastography, FGF-21, Fibrosis Level 3, Fibrosis Level 4, Intercept Pharmaceuticals, inventiva, lanifibranor, Lean NASH, Madrigal, MRI-PDFF, NASH, non-invasive liver testing, Obesity, obeticholic acid, seladelpar, Semaglutide, TrialDesign, Backbone therapy, resmetirom, polygenic risk scores, dyslipidemia, glycemia, FGF-19, payers, drug costs, 4th Global NASH Congress, de-escalating therapy, combination therapy,

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