Hepatology: Emerging Paradigms in MASLD, Viral Hepatitis, Cholestatic Liver Disease, Portal Hypertension and Hepatocellular Carcinoma
Year: 2026
Type: article
Abstract: The Paris International Liver Meeting (January 19-21, 2026) brought together leading hepatology experts to discuss transformative advances in chronic liver disease management. The meeting highlighted pivotal developments reflecting the field's evolution from disease characterisation toward precision, mechanism-based therapeutics. Metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), were highlighted, marking the transition to an era of approved disease-modifying therapies. Resmetirom and semaglutide are now approved for MASH with F2-F3 fibrosis, with a robust pipeline generating anti-fibrotic signals through FGF21 analogs, pan-peroxisome proliferator-activated receptor (PPAR) agonists, and incretin-based dual and triple agonists. Non-invasive tests have evolved beyond their original diagnostic role to enable prognostic stratification, screening of at-risk populations, treatment selection, and monitoring of therapeutic response. This evolution is not limited to MASLD, but extends to other chronic liver diseases, including primary biliary cholangitis (PBC) and portal hypertension, as highlighted by the recommendations of the Baveno Consensus Workshops. Hepatitis B and D are moving toward functional cure strategies, with simplified HBV treatment algorithms based on fibrosis and viral load, supported by biomarkers for risk stratification and safe treatment discontinuation. In parallel, HDV management is transitioning from a severe disease to one with emerging suppressive and potential curative l through bulevirtide and novel HBsAg-targeting and RNA-silencing therapies, respectively. Management of PBC has advanced with novel PPAR agonists that improve cholestatic biochemistry and pruritus, supported by individualised risk stratification. However, significant treatment gaps persist, with fewer than half of eligible PBC patients receiving second-line therapy, and fatigue remains a major unmet clinical need. Furthermore, effective pharmacotherapies for primary sclerosing cholangitis (PSC) remain a major challenge, and no approved disease-modifying treatments are currently available. Finally, for patients with hepatocellular carcinoma (HCC), immunotherapy combinations can achieve unprecedented long-term survival in selected populations of patients. Collectively, these advances define a new era of hepatology centered on precision medicine, earlier intervention, and mechanism-driven therapeutic strategies.
Source: Liver International
DOI: 10.1111/liv.70806
Authors: Zobair M. Younossi, George Papatheodoridis, Emmanuel Tsochatzis, Maria Buti, Lorenza Rimassa, Massimo Pinzani, Ana Lleo, Debbie Shawcross, Frank Tacke, Vincent Wai‐Sun Wong, Shira Zelber‐Sagi, Andreas E. Kremer, David J. Pinato, Josep M. Llovet, Paolo Angeli, Tarik Asselah, Nicola Pugliese, Cyrielle Caussy, Annalisa Berzigotti, Pietro Lampertico, Markus Cornberg, Mads Israelsen, Pere Gines, Sabela Lens, Hannes Hagström, Michael Trauner, Paul Brennan, Jérôme Boursier, Maurizia Brunetto, Mark Thursz, Elisabetta Bugianesi, Claire Carette, Elisabetta Degasperi, François Durand, Jean‐François Dufour, Sven Francque, Claire Francoz, Jean‐François Gautier, Helena Hernandez‐Evole, David Jones, Maurice Michel, Christophe Moreno, Thomas Mouillot, Lucia Parlati, Jean‐Michel Pawlotsky, Pierre‐Emmanuel Rautou, Thomas Reiberger, Olivier Roux, Michael Betel, Dominique Thabut, Mazen Noureddin, Valérie Vilgrain, Elise Vuille‐Lessard, Yusuf Yilmaz, Adrian Gadano, Vlad Ratziu, Jörn M. Schattenberg, Ramon Bataller, Lawrence Serfaty, Maja Thiele, Alessio Aghemo, Laurent Castera
Institutions: Georgetown University, National and Kapodistrian University of Athens, Laiko General Hospital of Athens, The Royal Free Hospital, University College London, Vall d'Hebron Hospital Universitari, Humanitas University, IRCCS Humanitas Research Hospital, King's College London, Charité - Universitätsmedizin Berlin, Chinese University of Hong Kong, University of Haifa, University of Zurich, University Hospital Zurich, Università degli Studi del Piemonte Orientale “Amedeo Avogadro”, Hammersmith Hospital, Imperial College London, Institució Catalana de Recerca i Estudis Avançats, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Tisch Cancer Institute, Universitat de Barcelona, Icahn School of Medicine at Mount Sinai, University of Padua, Inserm, Université Paris Cité, Hôpital Beaujon, Centre de Recherche sur l'Inflammation, Hospices Civils de Lyon, Hôpital Lyon Sud, University of Bern, University Hospital of Bern, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Medizinische Hochschule Hannover, Odense University Hospital, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Karolinska University Hospital, Karolinska Institutet, Medical University of Vienna, University of Dundee, Ninewells Hospital, Centre Hospitalier Universitaire d'Angers, Université d'Angers, University of Pisa, Azienda Ospedaliera Universitaria Pisana, University of Turin, Antwerp University Hospital, Hôpital Lariboisière, NIHR Newcastle Biomedical Research Centre, Newcastle University, Universitätsklinikum des Saarlandes, Saarland University, Université Libre de Bruxelles, Erasmus Hospital, CHU Dijon Bourgogne, Centre de recherche Translationnelle en Médecine moléculaire, Université Bourgogne Europe, Hôpital Cochin, Assistance Publique – Hôpitaux de Paris, Université Paris-Est Créteil, Hôpitaux Universitaires Henri-Mondor, Fatty Liver Alliance, Sorbonne Université, Pitié-Salpêtrière Hospital, Houston Methodist, Recep Tayyip Erdoğan University, Hospital Italiano de Buenos Aires, Fondation pour l’innovation en Cadiométabolisme et Nutrition, Hôpital Civil, Strasbourg, Université de Strasbourg
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7203694613