---
title: >-
  Changes in The Fibrosis-4 (FIB-4) Score Accurately Reflects The Disease
  Trajectory of Metabolic Dysfunction Associated Steatotic Liver Disease.
description: >-
  Explore this publication on real-world evidence: Changes in The Fibrosis-4
  (FIB-4) Score Accurately Reflects The Disease Trajectory of Metabolic
  Dysfunction…
date: '2025-01-01'
category: Publications
tags:
  - AASLD
  - Poster Presentation
  - R&D
  - Care
  - Hepatology
  - MASH/MASLD
  - Health System Partner
canonical_url: >-
  https://www.pedestalhealth.com/resources/publications/aasld/changes-in-the-fibrosis-4-fib-4-score-accurately-reflects/
source: Pedestal Health
license: © 2026 Pedestal Health. All rights reserved.
slug: changes-in-the-fibrosis-4-fib-4-score-accurately-reflects
id: 1T6q04EsDeyVNPhsuIlkw1
contentType: article
---

## Challenge

FIB-4 is widely used in the intermediate risk range (1.3–2.6) but its utility for tracking disease trajectory over time—as opposed to classifying risk at a single point—had not been validated against hard clinical outcomes in a large real-world MASLD cohort.

## Solution

A retrospective analysis of TARGET-NASH patients with FIB-4 values in the intermediate range and ≥2 measurements over three years was conducted, with time-to-event models linking FIB-4 change categories to MALO and mortality outcomes in the subsequent follow-up period.

## Impact

Demonstrating that FIB-4 trajectory accurately predicts future adverse liver outcomes provides regulatory-grade evidence for the use of longitudinal FIB-4 as a monitoring and enrichment tool in MASLD trials, and supports its use as a surrogate endpoint component in real-world drug evaluation.

### [Breda Munoz](/people/breda-munoz/)

![Breda Munoz, PhD — Profile Photo](https://images.ctfassets.net/h4s3ip99qawo/3H1T2mfvSNFj6w9tulnreq/a74ae05fe53e400f176d4e9c617b8fb8/breda-munoz.jpg)

### [Andrea R. Mospan](/people/andrea-mospan/)

![Andrea R. Mospan, PhD, RAC — Profile Photo](https://images.ctfassets.net/h4s3ip99qawo/4w6bkwPHPqrXKYs4tHZPkK/1d21763b54ecc3466764986693b7072f/andrea-mospan.jpg)