7 Hepatology Headlines You Missed in November 2025

November brought a series of impactful developments in hepatology, underscoring both therapeutic momentum and ongoing challenges across liver disease. The American Association for the Study of Liver Diseases (AASLD) opened the month with updated practice guidance on semaglutide for metabolic dysfunction-associated steatohepatitis (MASH), marking the first major revision since the organization’s 2023 NAFLD guidance and reflecting rapid evolution in MASLD/MASH care. New investigational data also signaled a shift in long-held assumptions about cirrhosis, with early findings from the phase 2 WAYFIND trial exploring combination therapy with semaglutide, cilofexor, and firsocostat in patients with compensated MASH cirrhosis.

At AASLD The Liver Meeting 2025, attention turned to a transformed cholestatic liver disease landscape following the withdrawal of obeticholic acid. Real-world data added clarity on seladelpar’s role in PBC management, particularly for patients transitioning from obeticholic acid. Complementary long-term findings from the ELATIVE extension study reinforced elafibranor’s durability and safety as a second-line therapy. Meanwhile, the ALTUS study introduced promising evidence that a new multi-target blood test could outperform abdominal ultrasound for early hepatocellular carcinoma (HCC) detection.

Rounding out the month, new research illuminated disparities across liver disease, including heightened fibrosis risk among women who binge drink and the strong association between socioeconomic and environmental disadvantage and pediatric MASLD, emphasizing the continued need for equity-focused approaches in hepatology.

Check out this November 2025 hepatology month in review for a recap of HCPLive’s coverage of the top hepatic news and research from the past few weeks:

Updates in MASH Care

AASLD Releases Updated Practice Guidance on Semaglutide (Wegovy) for MASH

On November 7, 2025, the AASLD released an updated practice guidance on semaglutide (Wegovy) therapy for MASH. The document was published in Hepatology and serves as an update to the 2023 AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease (NAFLD), now known as MASLD.

WAYFIND: Exploring Combination Therapy for MASH Cirrhosis, With Naim Alkhouri, MD

Despite historical perceptions of cirrhosis as an irreversible stage of chronic liver disease, emerging data from pharmacologic trials are challenging that notion. Among these, the phase 2 WAYFIND trial has drawn considerable attention for testing a novel combination approach of semaglutide alone and in fixed-dose combination with cilofexor and firsocostat in patients with biopsy-proven compensated cirrhosis due to MASH.

Headlines From AASLD The Liver Meeting 2025

Seladelpar’s Role in the Post-Obeticholic Acid PBC Treatment Landscape, With Christopher Bowlus, MD

The September 2025 voluntary withdrawal of obeticholic acid from the US market created a large therapeutic gap for PBC, removing what was once the sole second-line treatment option for patients who did not respond to or could not tolerate first-line ursodeoxycholic acid. With obeticholic acid no longer an option, clinical uncertainties have emerged regarding the safety and efficacy of switching these patients to the newly available second-line therapies elafibranor and seladelpar.

At AASLD The Liver Meeting 2025, Christopher Bowlus, MD, the Lena Valente Professor and Chief of the division of gastroenterology and hepatology at the University of California Davis School of Medicine, presented late-breaking, real-world data supporting the use of seladelpar in patients with PBC, including those who switched from obeticholic acid.

Defining Elafibranor’s Role in a New Era of PBC Management, With Cynthia Levy, MD

Since its accelerated approval and the subsequent removal of obeticholic acid from the US market, elafibranor has played a pivotal role in second-line treatment for PBC. Now, new > 3-year data from the ongoing ELATIVE open-label extension presented at AASLD The Liver Meeting 2025 demonstrate continued rapid, sustained, and reproducible responses in clinically relevant biomarkers of cholestasis as well as positive effects on cholestasis, sustained improvement in pruritus and fatigue, stabilization of markers of fibrosis, and a consistent safety profile.

ALTUS: Multi-Target Blood Outperforms Ultrasound for HCC, With Binu John, MD, MPH

Findings from the prospective multicenter ALTUS study suggest Exact Sciences’ Oncoguard® Liver blood test, a new multi-target blood test, delivers superior early-stage and overall sensitivity for hepatocellular carcinoma (HCC) compared to standard of care abdominal ultrasound.

Liver Disease Disparities

Women Face Higher Risk of Advanced Fibrosis Due to Binge Drinking Than Men

New research sheds light on sex-based differences in the association between the frequency of binge drinking and advanced fibrosis, highlighting a heightened risk of liver injury among women even at low binge frequencies. Study findings pose important implications for the accuracy of current metabolic dysfunction-associated alcohol-related liver disease (MetALD) and alcohol-associated liver disease (ALD) definitions.

Socioeconomic, Environmental Disadvantage Linked to Pediatric MASLD Risk

Recent research suggests the presence of a significant association between social determinants of health (SDH) and MASLD in children with overweight or obesity. In the study, children with MASLD were more likely to live in neighborhoods with greater socioeconomic and environmental disadvantage than their peers with overweight or obesity but without MASLD. Specifically, they were more likely to reside in neighborhoods with lower socioeconomic advantage, reduced access to education and economic resources, poorer housing conditions, and greater environmental risks, including higher air pollution exposure.

References

1. Brooks A. AASLD Releases Updated Practice Guidance on Semaglutide (Wegovy) for MASH. HCPLive. November 7, 2025. Accessed December 4, 2025. https://www.hcplive.com/view/aasld-releases-updated-practice-guidance-semaglutide-wegovy-mash

2. Alkhouri N. WAYFIND: Exploring Combination Therapy for MASH Cirrhosis, With Naim Alkhouri, MD. HCPLive. November 18, 2025. Accessed December 4, 2025. https://www.hcplive.com/view/wayfind-exploring-combination-therapy-for-mash-cirrhosis-with-naim-alkhouri-md

3. Bowlus C. Seladelpar’s Role in the Post-Obeticholic Acid PBC Treatment Landscape, With Christopher Bowlus, MD. HCPLive. November 9, 2025. Accessed December 4, 2025. https://www.hcplive.com/view/seladelpar-role-post-obeticholic-acid-pbc-treatment-landscape-with-christopher-bowlus-md

4. Levy C. Defining Elafibranor’s Role in a New Era of PBC Management, With Cynthia Levy, MD. HCPLive. November 13, 2025. Accessed December 4, 2025. https://www.hcplive.com/view/defining-elafibranor-role-new-era-pbc-management-with-cynthia-levy-md

5. John B. ALTUS: Multi-Target Blood Outperforms Ultrasound for HCC, With Binu John, MD, MPH. HCPLiveNovember 11, 2025. Accessed December 4, 2025. https://www.hcplive.com/view/altus-multi-target-blood-outperforms-ultrasound-hcc-john-binu-md-mpd

6. Brooks A. Women Face Higher Risk of Advanced Fibrosis Due to Binge Drinking Than Men. HCPLive. November 7, 2025. Accessed December 4, 2025. https://www.hcplive.com/view/women-face-higher-risk-advanced-fibrosis-due-binge-drinking-than-men

7. Brooks A. Socioeconomic, Environmental Disadvantage Linked to Pediatric MASLD Risk. HCPLive. November 24, 2025. Accessed December 4, 2025. https://www.hcplive.com/view/socioeconomic-environmental-disadvantage-linked-pediatric-masld-risk