{
  "society": "EASL",
  "version": "2024",
  "publication_date": "2024-06-01",
  "title": "EASL-EASD-EASO Clinical Practice Guidelines on the management of MASLD",
  "status": "published",
  "recommendations": [
    {
      "recommendation_id": "EASL-2024-R01",
      "topic": "definition",
      "text_en": "EASL endorses the MASLD nomenclature with cardiometabolic criteria; aligns with multi-society Delphi consensus 2023.",
      "text_kr_summary": "EASL는 MASLD 명명법 채택, 심대사 기준 적용.",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["37363821"],
      "related_nits": [],
      "related_drugs": []
    },
    {
      "recommendation_id": "EASL-2024-R02",
      "topic": "screening",
      "text_en": "Screen patients with T2DM and metabolic syndrome using FIB-4 as first-tier NIT.",
      "text_kr_summary": "T2DM·대사증후군 환자 FIB-4로 1차 NIT.",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["33271056"],
      "related_nits": ["FIB-4"],
      "related_drugs": []
    },
    {
      "recommendation_id": "EASL-2024-R03",
      "topic": "fib4_cutoff",
      "text_en": "FIB-4 < 1.3 low risk; > 2.67 high risk; 1.3-2.67 indeterminate -> second-tier (LSM, ELF).",
      "text_kr_summary": "FIB-4 layered: <1.3 저, >2.67 고, 1.3-2.67 중간.",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["17326139"],
      "related_nits": ["FIB-4"],
      "related_drugs": []
    },
    {
      "recommendation_id": "EASL-2024-R04",
      "topic": "lsm_cutoff",
      "text_en": "VCTE LSM: < 8 kPa exclude; 8-12 kPa intermediate; > 12 kPa significant fibrosis. Iceberg approach.",
      "text_kr_summary": "LSM <8 배제, 8-12 중간, >12 유의 섬유화.",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["32492532"],
      "related_nits": ["LSM"],
      "related_drugs": []
    },
    {
      "recommendation_id": "EASL-2024-R05",
      "topic": "cap_steatosis",
      "text_en": "CAP >= 248 dB/m: any steatosis; >= 268: moderate-severe; >= 280: severe steatosis.",
      "text_kr_summary": "CAP 248/268/280 dB/m steatosis 등급.",
      "strength": "conditional",
      "evidence_grade": "B",
      "cite_pmids": ["28986335"],
      "related_nits": ["CAP"],
      "related_drugs": []
    },
    {
      "recommendation_id": "EASL-2024-R06",
      "topic": "weight_loss",
      "text_en": "Lifestyle modification with >= 7% weight loss recommended; consider Mediterranean diet.",
      "text_kr_summary": "체중감소 >=7%, 지중해식 식단.",
      "strength": "strong",
      "evidence_grade": "A",
      "cite_pmids": ["25865049"],
      "related_nits": [],
      "related_drugs": []
    },
    {
      "recommendation_id": "EASL-2024-R07",
      "topic": "resmetirom",
      "text_en": "Resmetirom may be considered in F2-F3 MASH per FDA accelerated approval; awaiting EMA decision.",
      "text_kr_summary": "F2-F3 MASH에 레스메티롬 고려; EMA 심사 중.",
      "strength": "conditional",
      "evidence_grade": "B",
      "cite_pmids": ["38324483"],
      "related_nits": [],
      "related_drugs": ["resmetirom"]
    },
    {
      "recommendation_id": "EASL-2024-R08",
      "topic": "glp1",
      "text_en": "GLP-1 RA (semaglutide) and tirzepatide recommended for MASLD with T2DM/obesity.",
      "text_kr_summary": "T2DM/비만 MASLD에 세마글루타이드·티르제파타이드 권고.",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["33185364"],
      "related_nits": [],
      "related_drugs": ["semaglutide", "tirzepatide"]
    },
    {
      "recommendation_id": "EASL-2024-R09",
      "topic": "monitoring",
      "text_en": "FIB-4 every 1-3 years; LSM in high risk; biopsy if NITs discordant.",
      "text_kr_summary": "FIB-4 1-3년, 고위험 LSM, 불일치시 생검.",
      "strength": "conditional",
      "evidence_grade": "C",
      "cite_pmids": ["33340572"],
      "related_nits": ["FIB-4", "LSM"],
      "related_drugs": []
    },
    {
      "recommendation_id": "EASL-2024-R10",
      "topic": "pdff",
      "text_en": "MRI-PDFF >= 5% defines steatosis; >= 10% moderate; >= 30% severe; useful for trial enrollment and treatment monitoring.",
      "text_kr_summary": "PDFF >=5% steatosis, 10% 중등도, 30% 중증.",
      "strength": "conditional",
      "evidence_grade": "B",
      "cite_pmids": ["32294531"],
      "related_nits": ["PDFF"],
      "related_drugs": []
    },
    {
      "recommendation_id": "EASL-2024-R11",
      "topic": "mre",
      "text_en": "MRE >= 2.5 kPa significant fibrosis; >= 3.5 kPa advanced fibrosis.",
      "text_kr_summary": "MRE >=2.5 유의, >=3.5 진행 섬유화.",
      "strength": "conditional",
      "evidence_grade": "B",
      "cite_pmids": ["27568284"],
      "related_nits": ["MRE"],
      "related_drugs": []
    },
    {
      "recommendation_id": "EASL-2024-R12",
      "topic": "alcohol",
      "text_en": "MetALD requires alcohol intake assessment; advise reduction below moderate threshold.",
      "text_kr_summary": "MetALD 음주력 평가, 절주 권고.",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["37363821"],
      "related_nits": [],
      "related_drugs": []
    }
  ]
}