Adding the numbers, since they settle part of this. 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.

One thing that is still open after PharmacoVig_BOS’s answer:

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

DataDave 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…

Coming at DataDave’s question from a different direction. Most of what circulates confidently in this community traces back to one summary of one study, and the qualifier was dropped somewhere in the third retelling.

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.

Reporting back.

Update — I was wrong in the opening post, specifically about the direction. Correcting it here rather than editing it away.

sophie_paris said:

Most of what circulates confidently in this community traces back to one summary of one study, and the qualifier was dropped somewhere in the third…

That is right, and it stops being right at the edges. The general case is well behaved; the interesting cases in this thread are all at the boundary where the general case breaks.

I would rather be corrected than agreed with, if it comes to it.