Nancy Reau, MD, is Professor of Internal Medicine, Richard B. Capps Chair of Hepatology, Associate Director of Solid Organ Transplantation, and Section Chief of Hepatology at Rush University Medical Center.

Nancy Reau, MD

Liver Lineup: Advances in MASH, PSC, and PBC Care at EASL 2025

Liver Lineup: Updates & Unfiltered Insights

, hosts Kimberly Brown, MD, a professor of Medicine at Michigan State University and Wayne State University, associate medical director of the Henry Ford Hospital Transplant Institute, and medical director of Transplant Outreach Services at Henry Ford Hospital, and Nancy Reau, MD, a professor of internal medicine, the Richard B. Capps Chair of Hepatology, associate director of solid organ transplantation, and the section chief of hepatology at Rush University Medical Center, continue their discussion on notable abstracts presented at the 2025 European Association for the Study of the Liver (EASL) Congress.

Check out part 1 of Liver Lineup’s EASL recap 

The hosts highlight an additional 3 abstracts of note from the meeting, starting with findings from the LITMUS study, a multicenter effort to identify noninvasive biomarkers that can accurately stage patients with at-risk 

metabolic dysfunction-associated steatohepatitis (MASH)

, particularly for inclusion in clinical trials. While many patients had baseline imaging and biomarker data correlated with liver biopsy, only the NIS4-2 test—a proprietary combination of 2 biomarkers—showed promise in identifying this “at-risk” group, though both hosts note that it is not yet commercially available.

Results showed widely used measures such as FIB-4 and VCTE alone underperformed for early-stage disease, to which Brown and Reau both express disappointment that reliable, accessible tools for frontline providers are still lacking—creating barriers to early referral and trial enrollment.

, the hosts discuss a promising interim analysis of an ongoing norursodeoxycholic acid trial. At week 96, results showed the bile acid therapy significantly reduced alkaline phosphatase levels compared to placebo, particularly in patients not receiving ursodeoxycholic acid. Notably, the hosts point out 25% of treated patients showed an improvement in fibrosis stage, and fewer progressed compared to placebo. Although early, Brown says the results suggest this agent may offer hope for a disease that currently has no approved therapy and a high risk of complications like cholangiocarcinoma.

Finally, Brown and Reau review a presentation on seladelpar, a newly approved PPAR agonist for the treatment of 

. In the study, investigators used the GLOBE score—a validated tool predicting transplant-free survival—to assess outcomes and found patients on seladelpar had significantly improved GLOBE scores, reinforcing the long-term benefit of the drug beyond surrogate markers like ALP and bilirubin. While both hosts admit they do not routinely calculate the score in clinical practice, they emphasize its value in post-marketing evaluation, especially given the challenges of proving outcome benefit in a slowly progressive disease like PBC.

Reau concludes the episode with optimism about the progress being made for PBC and hope that similar breakthroughs for PSC, alcohol-associated liver disease, and MASLD are on the horizon.

Editors’ note: Relevant Disclosures for Reau include AbbVie, Gilead, Salix, Arbutus, and VIR. Relevant disclosures for Brown include Mallinckrodt Pharmaceuticals, Gilead, Salix, Intercept, Ipsen, and Madrigal.

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In the second part of a 2-part episode, hosts Kimberly Brown and Nancy Reau break down 3 more notable abstracts from the 2025 EASL Congress.

Liver Lineup: New MASLD and PBC Agents, PEth Testing, and HBV Functional Cure at EASL 2025

, hosts Kimberly Brown, MD, a professor of Medicine at Michigan State University and Wayne State University, associate medical director of the Henry Ford Hospital Transplant Institute, and medical director of Transplant Outreach Services at Henry Ford Hospital, and Nancy Reau, MD, a professor of internal medicine, the Richard B. Capps Chair of Hepatology, associate director of solid organ transplantation, and the section chief of hepatology at Rush University Medical Center, highlight 4 key abstracts presented at the 2025 European Association for the Study of the Liver (EASL) Congress.

The hosts begin by discussing data presented on a new fibroblast growth factor 21 (FGF21) analog, efimosfermin alfa, citing the agent’s fast-acting impact on fibrosis in patients with 

. Brown highlights its once-monthly subcutaneous administration and notes reductions in pro-fibrotic markers as soon as 4 weeks, indicating early improvements in fibrosis that were sustained through week 24 of the study.

Reau calls attention to the antifibrotic nature of efimosfermin alfa, citing delayed antifibrotic effects in other currently approved agents as well as agents that are currently in clinical development and expected to eventually earn approval. The duo also notes the favorable safety profile of the drug, describing the lack of severe side effects observed thus far.

The second abstract they highlight from EASL examines the use of phosphatidylethanol (PEth) testing to monitor alcohol intake in patients with alcohol-associated liver disease and confirm their self-reported alcohol consumption using an objective, blood-based biomarker. Brown describes discordance between patients’ reported alcohol consumption and their PEth levels in the study, noting the significance of now having confirmatory testing that can better categorize these patients and aid risk stratification in the context of clinical trials.

Reau notes that her institution primarily conducts PEth testing in patients being considered for transplantation, to which Brown asserts that more clinical trials should be using this tool to increase understanding of its value in clinical practice. She also describes its use in patients presenting as donors.

Reau then introduces the third abstract examining data from the RETRACT-B cohort, a global, multicenter observational project evaluating the feasibility of stopping nucleos(t)ide analog therapy in 

 patients with long-term viral suppression. She explains that while current long-term maintenance HBV treatments are “excellent” at viral suppression, patients often want to know that they do not need to take medication for forever.

RETRACT-B findings presented at EASL suggest those with low surface antigen levels have the greatest chance of success, but reaffirm that discontinuation is not for everyone – some patients experience recurrence, flares, and decompensation events. Both experts highlight treatment discontinuation in patients with cirrhosis, something they say they likely would not consider for these patients due to the risk of decompensation.

The fourth and final EASL abstract Brown and Reau highlight is the phase 3 GLISTEN trial of linerixibat in patients with 

 and cholestatic pruritus, data Reau refers to as a “success story,” highlighting early, significant, and sustained itch relief with use of the ileal bile acid transporter (IBAT) inhibitor.

Despite these positive data, both experts note that IBAT inhibitors are currently approved for Alagille syndrome and progressive familial intrahepatic cholestasis but have not yet been granted approval for pruritus in PBC.

Editors’ note: Relevant Disclosures for 

 include AbbVie, Gilead, Salix, Arbutus, and VIR. Relevant disclosures for 

 include Mallinckrodt Pharmaceuticals, Gilead, Salix, Intercept, Ipsen, and Madrigal.

Hosts Kimberly Brown and Nancy Reau break down 4 of the top abstracts presented at the 2025 European Association for the Study of the Liver (EASL) Congress.

 — an exciting new podcast delivering timely, candid perspectives on the most pressing topics in the fast-moving world of 

. Created by Nancy Reau, MD, and Kimberly Brown, MD, and hosted by 

, this series dives into the cutting edge of liver disease research, clinical care, and real-world practice.

Intended for hepatologists, gastroenterologists, and other clinicians managing liver disease, 

 will unpack the latest research, debate emerging controversies, and spotlight developments that could shape — or sharpen — day-to-day practice, all with unfiltered perspective and clarity.

Brown is division chief of gastroenterology and hepatology and the Associate Medical Director of the Henry Ford Hospital Transplant Institute at Henry Ford Hospital. She is also a Professor of Medicine at Wayne State University

Reau is a professor of internal medicine, the Richard B. Capps Chair of Hepatology, Associate Director of Solid Organ Transplantation, and the section chief of Hepatology at Rush University Medical Center.

In the inaugural episode, Brown and Reau introduce the mission behind 

and share why they created the podcast. Driven by a shared commitment to education, clinical excellence, and elevating the conversation around liver disease, the hosts describe their hope to offer practicing clinicians a clear, concise, and engaging way to keep up with the latest news and innovations in hepatology. They aim to highlight data that’s not only new, but meaningful — spotlighting developments that can improve patient care today and shape best practices tomorrow.

Together, the Brown and Reau set the stage for what’s to come: expert commentary on major liver meetings including Digestive Disease Week, European Association for the Study of the Liver Congress, The Liver Meeting from the American Association for the Study of Liver Diseases, and the American College of Gastroenterology Annual Meeting; coverage of key topics like MASLD, liver cancer, viral hepatitis, and transplant; and conversations with colleagues across the hepatology spectrum. From debates over practice-changing data to discussions on care pathways and diagnostics, 

 aims to keep clinicians informed, engaged, and ready to translate insight into impact.

Looking ahead, Brown and Reau preview upcoming episodes covering major hepatology updates from Digestive Disease Week 2025 and European Association for the Study of the Liver Congress 2025 — with more to follow throughout the year.

Liver Lineup: Updates & Unfiltered Insights is a hepatology podcast from HCPLive hosted by Nancy Reau, MD, and Kimberly Brown, MD, exploring the latest news and research in liver disease.

Thoughts on the Current State of PBC Management

Video content above is prompted by the following:

Please share your concluding thoughts about management of PBC.

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Primary biliary cholangitis (PBC) is an autoimmune liver disease characterized by the progressive destruction of small and medium-sized bile ducts within the liver. This destruction is primarily mediated by autoreactive T lymphocytes targeting the epithelial cells of the bile ducts. The ensuing cholestasis leads to the accumulation of toxic bile acids, causing hepatocellular damage and inflammation. Over time, this chronic inflammatory process results in fibrosis and eventually cirrhosis. The pathophysiology of PBC is influenced by genetic predispositions and environmental factors, contributing to its complex etiology and progression.

The panel of experts offers expert insights and concluding thoughts on the management of primary biliary cholangitis (PBC), emphasizing the importance of personalized treatment strategies, monitoring, and the evolving role of new therapies in improving patient outcomes.

Nancy Reau, MD

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