Academic Debate: Is Resmetirom or Semaglutide the Best First-Line Treatment for Metabolic Dysfunction–Associated Steatohepatitis With Stage 2–3 Fibrosis?

​​​​​Explore timely topics in liver disease in a lively debate format as hepatology trainees and practicing hepatologists tackle important often controversial issues. Debaters gain skills in critical thinking, balanced argumentation, and factual examination of each issue’s pros and cons. Debaters, judges, and audience members grapple with opposing scientific, societal, individual, and financial viewpoints on current clinical concerns. This session highlights teams of 2 fellows supported by faculty mentors who present arguments in support of or against a question theme. This year's debate question is: "Is Resmetirom or Semaglutide the Best First-Line Treatment for Metabolic Dysfunction–Associated Steatohepatitis With Stage 2–3 Fibrosis for a Specific Clinical Vignette?" 

MASH is a common clinical condition that, if untreated, can lead to the development of cirrhosis and liver decompensation. Currently, there are only 2 US Food and Drug Administration–approved medications for MASH with stage 2–3 fibrosis that have the potential for MASH resolution and fibrosis regression: resmetirom and semaglutide. Which medication is the best first-line therapy is unclear. One debate team argues resmetirom is the best first-line choice; the other argues that semaglutide is the best first-line choice.