DAY 2: Non-Invasive Monitoring Tool Enables Earlier Assessment of Treatment Response in Patients with Liver Fibrosis

Emerging clinical data have continued to reinforce the role of LIVERFASt, a noninvasive blood-based test, as a reliable option for the longitudinal monitoring of patients who initiate resmetirom therapy. Real-world findings presented at the 2026 Annual Scientific Meeting of the American College of Gastroenterology showed that LIVERFASt may provide earlier insights into therapeutic response and disease progression in patients being treated for metabolic dysfunction–associated steatohepatitis (MASH) compared to other noninvasive monitoring modalities. 

Previous research has shown that LIVERFASt is a highly sensitive diagnostic test for staging fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), including those with type 2 diabetes, suggesting that it may outperform other noninvasive modalities such as Fibrosis-4 F(IB-4) scores in detecting advanced fibrosis [Alkhouri N et al. J Gastrointestin Liver Dis 2025;34:437-450]. 

Data collected from 147 patients treated for MASH at Methodist Dallas Medical Center in Dallas, Texas showed that LIVERFASt performed as well as standard monitoring tools like vibration-controlled transient elastography (VCTE/FibroScan) in monitoring histologic remodeling through repeat assessments. Of the 147 patients who were assessed with LIVERFASt at baseline, 88 had FIB-4 data and 41 underwent VCTE assessments. 

The retrospective analysis showed that LIVERFASt reflected significant fibrosis regression (≥10%) as early as the third month after initiating resmetirom therapy, regardless of the daily dose (80 mg or 100 mg). LIVERFASt also proved effective for assessing steatosis regression in patients treated with resmetirom. Improvements in fibrosis scores were consistent between LIVERFASt and VCTE, reflecting the expected histologic remodeling during therapy. However, FIB-4 scores showed less change at reassessment, suggesting that this index may have limited ability to track fibrosis regression. 

Presenting author Mona Munteanu, MD, PhD noted that using LIVERFASt for repeat assessments may also provide clinicians with a more complete picture of patients’ liver health over time by reflecting changes in various biomarkers, including lipoproteins, triglycerides, and liver enzymes, in response to therapy. 

Lead author Jeevin Singh Sandhu, DO, an internal medicine resident at Methodist Dallas Medical Center, added that LIVERFASt may perform better than VCTE or may complement VCTE findings when monitoring patients with obesity, in whom physical and anatomical limitations can reduce the sensitivity and reliability of ultrasound-based imaging techniques. The initial cohort monitored at Methodist Dallas Medical Center included a large proportion of overweight patients, with an overall body mass index of 33. As more patients with MASH initiate resmetirom therapy, using LIVERFASt along with other noninvasive modalities for monitoring fibrosis and steatosis can equip clinicians with a robust framework for evaluating liver health longitudinally. Additional results will be presented in November at The Liver Meeting 2026, organized by the American Association for the Study of Liver Diseases.