Abstract
Metabolic associated fatty liver disease (MAFLD) is closely related to obesity, insulin resistance and metabolic syndrome and has become the main cause of chronic liver disease worldwide. Lifestyle intervention is the first-line treatment for MAFLD, and with the deepening of research on its pathogenesis, there have been breakthrough advancements in pharmacological therapies. Resmetirom, a thyroid hormone receptor β agonist, has become the first approved drug for the treatment of metabolic associated steatohepatitis (MASH). Additionally, fibroblast growth factor-21 analogs, incretin receptor agonists and sodium-glucose cotransporter 2 inhibitors have also achieved positive results. However, MAFLD/MASH treatment still faces many challenges: uncertain long-term drug efficacy and low histological response rate, lack of efficacy data for special populations such as children and the elderly, and limited evidence of metabolic outcome benefits. Therefore, future research needs to focus on multidisciplinary treatment, precision medicine, and combined therapies targeting liver and metabolic aspects to promote the development of personalized treatment for MAFLD/MASH.