{
  "society": "APASL",
  "version": "2025_update",
  "publication_date": "2025-11-01",
  "title": "APASL 2025 update: resmetirom adoption and Asian-specific NIT data",
  "status": "published",
  "recommendations": [
    {
      "recommendation_id": "APASL-2025-R03",
      "topic": "fib4_cutoff",
      "text_en": "FIB-4 < 1.3 low risk; > 2.67 high; age >= 65 (Asian) use 2.0; further validation in Korean/Japanese cohorts.",
      "text_kr_summary": "FIB-4 cutoff 유지; 한국/일본 추가 검증.",
      "strength": "strong",
      "evidence_grade": "A",
      "cite_pmids": ["17326139", "31430416", "39501010"],
      "related_nits": ["FIB-4"],
      "related_drugs": [],
      "supersedes": ["APASL-2024-R03"]
    },
    {
      "recommendation_id": "APASL-2025-R11",
      "topic": "resmetirom",
      "text_en": "Resmetirom may be considered in Asian non-cirrhotic F2-F3 MASH patients pending regional regulatory approval; PMDA/MFDS submission underway.",
      "text_kr_summary": "아시아 F2-F3 MASH에 레스메티롬 고려; PMDA/MFDS 심사 중.",
      "strength": "conditional",
      "evidence_grade": "B",
      "cite_pmids": ["38324483"],
      "related_nits": [],
      "related_drugs": ["resmetirom"]
    },
    {
      "recommendation_id": "APASL-2025-R12",
      "topic": "lsm_cutoff",
      "text_en": "VCTE LSM: < 8 kPa rule out; 8-15 kPa indeterminate; >= 15 kPa rule in (Asian-specific data adopted, raised from 12).",
      "text_kr_summary": "LSM rule-in 12->15 kPa (아시아).",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["32492533", "39501011"],
      "related_nits": ["LSM"],
      "related_drugs": [],
      "supersedes": ["APASL-2024-R04"]
    }
  ]
}