The SYNCHRONIZE-1 trial was a Phase III double-blind study in which patients with elevated BMI were randomized in a one-to-one-to-one ratio to placebo, 3.6 mg, or 6.6 mg of survodutide alongside lifestyle counseling, with the primary endpoint of at least 5% weight loss at week 76.
Noureddin framed the emergence of dual GLP-1/glucagon receptor agonism as a significant development, placing it alongside artificial intelligence as a transformative force in medicine, noting that while GLP-1 receptor agonists have already improved the management of metabolic syndrome and generated robust data across obesity and cardiovascular outcomes, the bar has now moved higher, with tolerability, injection frequency, oral versus injectable delivery, and liver-specific activity all emerging as key differentiators among the next generation of incretin-based therapies.
Noureddin acknowledged the extraordinary challenge facing primary care physicians who are tasked with managing a patient holistically across rapidly evolving fields and expressed genuine appreciation for the breadth of responsibility they carry.
Body surface area offers a simple starting point for gauging vitiligo severity, but the panel argues that phenotype markers, anatomic location, and disease activity carry more weight in shaping treatment urgency than surface area alone.
Noureddin outlined the striking epidemiological burden of MASLD and MASH in patients with obesity, with prevalence climbing dramatically with increasing BMI, reaching up to 90% in patients with a BMI of 40 or higher, and affecting approximately 60% of individuals with type 2 diabetes.
Angela Lamb discussed the switching data from the LEVEL UP trial, noting that patients who had not met treatment goals on dupilumab and switched to upadacitinib were able to achieve meaningful improvements, reinforcing the message to patients that failure on one biologic does not preclude success with another.
Vitiligo's clinical course splits into segmental and non-segmental presentations, each carrying a distinct prognosis. Dr. Rosmarin explains how disease activity, not just extent, determines whether a patient needs urgent intervention or watchful monitoring.
Noureddin framed MASH as one that should not be viewed in isolation by hepatologists or any other specialist, but rather understood as part of a broader cardio-liver-renal metabolic syndrome that demands comprehensive, multidisciplinary management, noting that even lean individuals with elevated visceral fat and insulin resistance can develop MASLD, and that the risk increases substantially with higher BMI and the presence of type 2 diabetes, which is strongly associated with both higher MASLD prevalence and greater rates of advanced fibrosis and cirrhosis.
Angela Lamb discussed how advanced therapy selection — spanning interleukin-4 (IL-4), IL-13, and IL-31 inhibitors as well as oral Janus kinase (JAK) inhibitors — is guided by patient phenotype, age-based restrictions, disease severity, and whether the presentation is more itch-dominant or body surface area (BSA)-dominant rather than a one-size-fits-all approach.
Nadege Gunn examined the stark economic contrast between the cost of early pharmacologic intervention in MASH and the astronomical healthcare utilization associated with late-stage liver disease, arguing that the cost of allowing MASH to progress unchecked to the point of hepatic decompensation, liver transplantation, or hepatocellular carcinoma far exceeds the investment required to treat the disease earlier with therapies capable of reversing fibrosis and resolving MASH before those devastating endpoints are reached.
Experts outline evolving EP-NEC care: smarter combo therapies, DLL3 targets, precise pathology, and why early clinical trials matter.
Gunn described her reaction to the SYNCHRONIZE-1 liver fat reduction data as genuinely compelling from a hepatology perspective, noting a reduction of up to 63% represents a level of hepatic fat clearance that could meaningfully transform the disease trajectory for patients, with the data also demonstrating reductions in non-invasive markers of fibrosis such as ELF and Pro-C3, adding further weight to the possibility that this combination could address not just fat accumulation but the fibrotic progression that drives the most serious liver-related morbidity.
Angela Lamb discussed how the lack of robust head-to-head comparative data across interleukin-targeting biologics contributes to biologic cycling, noting that without clear guidance on which agent best matches a given patient's immunologic drivers, clinician decision-making often relies on phenotype and clinical experience rather than predictive data.
Gunn explained the scientific rationale for combining GLP-1 and glucagon receptor agonism in the context of MASH, noting that the liver contains glucagon receptors, making the combination a compelling strategy for achieving more direct hepatic targeting than GLP-1 receptor agonism alone can provide.
This episode, titled ‘Emerging Data and the Future Treatment Landscape in Extrapulmonary Neuroendocrine Carcinoma: Novel Therapies, Algorithms, and Combination Strategies,’ featured panelists discussing the following critical questions
Learn how tumor and liquid biopsy biomarker tests are ordered, why results take weeks, and how insurance rules can delay cancer treatment.
This episode, titled 'Risk Stratification and Weight Loss as Therapy: A Hepatologist's Framework for Managing MASH Progression,' features Nadege Gunn, MD discussing the following critical questions: 1. How do you risk-stratify your patients, and what clinical or metabolic factors most reliably predict progression? 2. What does the literature tell us about the relationship between meaningful weight loss and fibrosis regression, and how does that inform your thinking about weight-loss therapy as a hepatic intervention?
In 'Screening MASH Upstream: Building a Practical, Scalable Algorithm for the Real World,’ Nadege Gunn, MD delves into the following critical question: 1. There is growing interest in screening for MASH further upstream. What would a practical, scalable screening algorithm look like in your view, and what are the limitations of that approach?
Payer delays and unpredictable coverage stall mental health meds, worsening symptoms, work performance, and ER risk while forcing clinicians into inefficient trial-and-error care.
Clinicians weigh generics versus new psychiatric meds, emphasizing evidence for treatment-resistant cases, staying current, and balancing costs, side effects, and whole-person care.
Learn how tumor and liquid biopsy testing fits care—plus insurance hurdles, turnaround delays, and the push for faster NGS results.
Angela Lamb examined the real-world challenges of capturing patient-reported outcomes in clinical practice, noting that while standardized pre-visit assessments and long-term tracking of quality of life and itch scores are theoretically ideal, implementation barriers such as varying electronic medical record (EMR) systems and competing clinical demands make consistent adoption difficult outside of clinical trial settings.
Explore evolving biomarker testing for rare neuroendocrine carcinomas—NGS, MSI/TMB, and emerging DLL3 targets guiding new trials.
In this episode, 'Screening, Risk Stratification, and the Multidisciplinary Care Model for MASH,' the hepatologist Nadege Gunn, MD explores the following questions: 1. How would you characterize the urgency of MASH as a public health problem for a primary care physician who may see the early signs? 2. In an ideal world, what does the multidisciplinary care model for a MASH patient with significant obesity look like? How far is current clinical practice from that ideal, and where do the current gaps exist?
Clinicians weigh generics, formularies and breakthrough psychiatry meds, from clozapine to esketamine, to treat resistance while managing costs, risks.
Welcome back to another AJMC Insights series. In this episode titled, 'MASH in Focus: How Patient Awareness, Clinical Empowerment, and Research Have Transformed the Field,' Nadege Gunn, MD led the conversation about the following questions: 1. As a hepatologist, how has the MASH patient population changed over the last decade? 2. Do you feel the broader medical community has kept pace with that shift? 3. How much of your current liver disease caseload would you attribute to metabolic and obesity-driven disease versus other etiologies?
Clinicians unpack why meds fail—patient fit, side effects, and adherence—and share practical ways to boost understanding and remission.
In this AJMC Insights episode, Angela Lamb discusses how clinicians diagnose and assess atopic dermatitis using clinical scoring tools and patient-centered goal setting, emphasizing the importance of evaluating both disease severity and patient-reported symptoms to guide individualized treatment decisions.
Experts explain evolving biomarker testing for rare neuroendocrine carcinomas, from NCCN gaps to DLL3 and NGS, guiding trials and treatment.
Learn how aggressive neuroendocrine carcinoma disrupts daily life—and why rapid treatment, strong caregiver support, and navigation resources matter.
