Clinical Characteristics of Patients With Presumed MASLD Who Meet Met-ALD Criteria in the TARGET-NASH Cohort.

Challenge

The MetALD subgroup—patients with MASLD criteria and elevated alcohol use—is clinically important but systematically excluded from most MASLD trials, leaving its cardiovascular risk profile, disease trajectory, and outcomes entirely uncharacterized in real-world settings.

Solution

The TARGET-NASH cohort was used to identify patients presumed to have MASLD who met MetALD criteria based on AUDIT scores, comparing their baseline characteristics, MACE incidence, time-to-event outcomes, and decompensation rates against the broader MASLD population.

Impact

Characterizing the MetALD subgroup in real-world practice informs eligibility criteria design for MASLD trials, supports the development of alcohol-aware diagnostic algorithms, and establishes the evidence base for including or appropriately excluding this high-risk population in drug development programs.