Clinical Management and Treatment Strategies for MetALD in the United States

Metabolic Dysfunction-Associated Steatotic Liver Disease with Alcohol (MetALD) is an emerging liver disease that combines features of both metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (ALD). As obesity, type 2 diabetes, and alcohol misuse increase in the U.S., MetALD is becoming a growing public health concern. However, awareness and standardized care for this condition remain limited. This presentation will review what is currently known about MetALD, including its prevalence, risk factors, and the clinical challenges it presents. A key focus will be on non-invasive ways to detect and assess MetALD, which are especially important given the risks of liver biopsy. We will discuss tools such as blood tests, fibrosis scoring systems, and imaging techniques like transient elastography. In terms of treatment, we will highlight the importance of a team-based, patient-centered approach. This includes reducing or stopping alcohol use, managing weight, and improving diet. Because MetALD involves both alcohol use and metabolic issues, care should involve specialists in liver disease, addiction, nutrition, and primary care. We will also discuss available medications and promising therapies under study. In summary, MetALD is a complex condition that requires early detection, coordinated care, and evidence-based treatment strategies to improve outcomes.