Resmetirom worked as well in MASH patients carrying high-risk genes as in those without

The edition in brief

Today's gastroenterology and hepatology edition closes on resmetirom and genetics. In a prespecified analysis of 738 patients with non-cirrhotic MASH and fibrosis from the phase 3 MAESTRO-NASH trial, the drug's effects on MASH resolution, fibrosis improvement, liver fat and biomarkers at 52 weeks were similar in carriers of high-risk PNPLA3, HSD17B13, TM6SF2, MTARC1 and MBOAT7 variants, individually or combined; the analysis was not powered for small differences. An AASLD expert practice opinion sets out the three roles that remain for liver biopsy — diagnosis, staging and guiding management — and compares percutaneous, transjugular and EUS-guided approaches. In 679 outpatients with cirrhosis across seven countries, 25% were admitted within 90 days; lower microbial diversity and 19 species were associated with admission, and adding microbiome data raised the AUC of a prediction model from 0.79 to 0.84. A 79-patient pilot of personalised EMDR or gut-directed hypnotherapy for IBS showed the approach was feasible but found no difference between personalised and reverse-personalised allocation. The pearl covers non-invasive fibrosis triage.