2024 Edition Book Updates

This explanation of the question mentions that there are no FDA-approved treatments for metabolic-associated steatohepatitis (MASH). Well, three months after the book's publication, the FDA approved Rezdiffra® (resmetirom) for non-cirrhotic, moderate to severe hepatic scarring.

This question is specifically asking what is the next best step in a patient undergoing lifestyle modifications without success with a BMI of 29 kg/m2. Pharmacotherapy is the best option for her. Pre-diabetes and pre-hypertension do not meet criteria for a comorbidity (for FDA-labeling), but pharmacotherapy can be used (technically off-label) in this patient as it is the most appropriate option, especially compared to the other answer choices. 

Answer choice E is increased heart rate. Patients on bupropion can experience increased heart rate per label, and thus could also be a correct answer. 

Change the "A postpartum female" to  "A female in her second trimester of pregnancy." 

Change answer D "Abnormality to EKG" to "Abnormality to echocardiogram."

Wegovy® 2.4 mg has now received an FDA indication for reducing cardiovascular risk (major adverse cardiovascular events, including death, heart attack, or stroke) in those with known cardiovascular disease and overweight or obesity, along with lifestyle changes. [SELECT trial]. This cardiovascular benefit is mentioned in Q 323, but now there is an official FDA indication.