One concrete data point for the thread. With resmetirom now available for MASH, combination approaches are being explored, so the standard of care in this area is moving faster than most threads assume.

A narrower follow-up, since the general answer is now clear:

Whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is?

dave_SLC said:

With resmetirom now available for MASH, combination approaches are being explored, so the standard of care in this area is moving faster than most…

There is a second half to this that has not been said yet. Whatever the answer turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, and invite the correction. That is slower than asserting, and it is the only version that survives being wrong.

OP back with an update, since a thread like this is useless without one.

Closing the loop. The answer turned out to depend on the detail I had left out of the opening post, which is a lesson about how to ask rather than about the subject.

Dr.KarenChen said:

Whatever the answer turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, and invite the…

Correct, and worth adding that it is reversible. Nothing being described here is a one-way door, which changes how cautious it is reasonable to be.

Worth separating that from liver and MASH, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.