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In an interview with Pharmacy Times, Nicole McMullin, regional clinical pharmacist at American Oncology Network, discussed AON’s development of an all-outpatient approach to step-up dosing for bispecific T-cell engager therapy in multiple myeloma.

An expert discusses a JAMA study that shows who depends on the MMRV combo shot and how policy shifts may widen gaps—plus how pharmacists keep kids on schedule.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is defined by the presence of macrovesicular steatosis in the setting of cardiometabolic risk factors.1 The more severe and progressive form of MASLD, metabolic dysfunction-associated steatohepatitis (MASH), is characterized by lobular inflammation and hepatocellular injury or ballooning with or without fibrosis.2 MASH represents a growing source of liver-related morbidity and mortality in the United States. Prior to 2024, treatment options for MASH were limited to lifestyle modifications, such as diet and weight loss, with no pharmacologic therapies approved by the FDA.3 Off-label use of agents targeting cardiometabolic comorbidities, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs), was common, but none were specifically indicated for MASH. In March 2024, resmetirom (Rezdiffra; Madrigal) became the first FDA-approved therapy for noncirrhotic MASH with moderate-to-advanced fibrosis following results from the MAESTRO-NASH trial (NCT3900429).4,5 Following approval, the American Association for the Study of Liver Diseases (AASLD) published practice guidance recommending serial liver function monitoring at 3, 6, and 12 months during the first year of therapy.6 However, implementation of this therapy in routine clinical practice presents several operational challenges, particularly surrounding laboratory monitoring and longitudinal follow-up. Although these recommendations provide a framework for safety monitoring, few real-world data exist regarding implementation of these workflows, or the operational burden associated with maintaining monitoring adherence. At the University of North Carolina (UNC) Liver Center, an embedded clinical pharmacist practitioner (CPP), a pharmacist with delegated authority to manage medications and monitor under collaborative practice, supports resmetirom management through patient education, laboratory coordination, and longitudinal monitoring. This retrospective study evaluated real-world resmetirom monitoring practices before and after publication of AASLD guidance. Study Overview A retrospective chart review was conducted among adult patients prescribed resmetirom within the UNC hepatology clinic between March 14, 2024, and August 1, 2025. The study was designed to evaluate laboratory monitoring practices and safety outcomes associated with resmetirom initiation before and after publication of AASLD guidance. Patients were divided into 2 cohorts based on the timing of resmetirom initiation relative to publication of AASLD guidance for monitoring. Cohort 1 (pre-guidance cohort) included patients who initiated resmetirom between March 14, 2024, and October 18, 2024. Cohort 2 (post-guidance) included patients who initiated resmetirom between October 19, 2024, and August 1, 2025. The primary outcome evaluated time to first liver function test (LFT) following resmetirom initiation. Secondary outcomes included completion of recommended LFT monitoring at 3, 6, and 12 months, documentation of laboratory reminder outreach, hepatotoxicity events, and treatment discontinuation. Key Findings A total of 98 patients met study inclusion criteria, including 28 in the pre-guidance cohort and 70 in the post-guidance cohort (Table 1). Median time to first LFT was numerically shorter in the post-publication of AASLD guidance group but did not significantly differ between groups (102.5 days vs 90 days; p = 0.12). Completion of recommended laboratory monitoring was numerically higher following publication of guidance, with 3-month, 6-month, and 12-month LFT completion rates increasing from 71.4% to 81.7%, 50.0% to 73.7%, and 42.9% to 53.6%, respectively. Documentation of laboratory reminder outreach increased substantially in the post-guidance cohort (3.6% vs 43.7%; p < 0.001), reflecting increased workflow coordination required to maintain longitudinal monitoring. Hepatotoxicity events were uncommon overall (0% vs 4.3%) and no patients experienced documented liver failure or hepatic decompensation during the study period. Lower treatment discontinuation rates were observed in the post-guidance cohort (42.9% vs 18.6%; p=0.013). Gastrointestinal adverse effects represent the most common reason for discontinuation. Clinical Implications for Pharmacists These findings demonstrate that implementation of resmetirom monitoring recommendations requires substantially more than simply prescribing therapy. Maintaining adherence to AASLD monitoring recommendations introduced meaningful operational workload involving laboratory ordering, patient outreach, reminder documentation, result review, and follow-up coordination. In busy hepatology practices, these responsibilities can become burdensome when managed solely by providers, particularly as the use of novel MASH therapies expands. The embedded hepatology CPP played a central role in facilitating these processes through longitudinal patient follow-up and structured monitoring support. Under collaborative practice agreements, the hepatology CPP provides longitudinal medication management, patient education, laboratory ordering and review, adverse effect assessment, and coordination of follow-up. This model allows physicians and advanced practice providers to share the operational and clinical responsibilities associated with long-term monitoring while providing additional touchpoints for patients receiving novel therapies. Although patients received counseling regarding recommended monitoring at therapy initiation, a substantial proportion still required additional outreach to complete laboratory testing. The marked increase in documented reminders following the publication of AASLD guidance likely reflects the additional coordination required to maintain adherence to monitoring recommendations. Despite multiple reminders, some patients still did not complete recommended labs. Implementation of AASLD monitoring recommendations required substantially more than laboratory ordering alone, necessitating coordination of patient outreach, reminder documentation, laboratory completion, and longitudinal follow-up. Although hepatotoxicity events were uncommon, the occurrence of laboratory abnormalities in a small proportion of patients supports continued surveillance during therapy. Lower discontinuation rates were observed in the post-guidance cohort; however, because the study was not designed to evaluate treatment persistence, the relationship between structured monitoring workflows and discontinuation remains uncertain. This finding represents an important area for future investigation. As additional therapies enter the MASH treatment landscape, pharmacists will likely play an increasingly important role in coordinating monitoring strategies, improving adherence to guidance recommendations, and supporting longitudinal disease management. Future Directions Future research should evaluate larger multi-center experiences with implementation of AASLD monitoring recommendations for resmetirom and explore whether pharmacist-supported workflows are associated with treatment persistence, safety monitoring adherence, and clinical outcomes. Additional investigation is also needed to better understand the relationship between structured follow-up processes and MASH treatment discontinuation, as well as the optimal integration of GLP-1 and GLP-1/ glucose-dependent insulinotropic polypeptide therapies alongside resmetirom in patients with MASH and cardiometabolic disease. AASLD guidance and embedded clinical pharmacist support significantly improved laboratory monitoring completion and reduced treatment discontinuation among patients on resmetirom for MASH.

TV-44749 is a subcutaneous long-acting injectable form of olanzapine that is effective in schizophrenia while avoiding risks seen with the intramuscular formulation.

Pharmacist-led pathways, multimodal analgesia, and patient-centered opioid stewardship may help improve acute pain management while balancing opioid safety, adequate pain relief, and access to emerging nonopioid options.

The approval of the drug combination is supported by findings from the phase 3 VIKTORIA-1 clinical trial.

Case counts will likely continue to rise as reporting catches up with the incubation lag.

Selpercatinib received approval for adults and children 2 years and older with previously treated or treatment-refractory RET fusion–positive solid tumors.

In an interview with Pharmacy Times, Brandon Kasberg, PharmD, discusses how pharmacists can help individualize multimodal acute pain regimens, reduce unnecessary opioid exposure, and support safer transitions from inpatient or postoperative care to the outpatient setting.

This FAQ breaks down which drugs are covered by the program, who qualifies, how to process claims correctly, and what pharmacists need to know to counsel patients through this landmark shift in obesity drug access.

Emerging data on psychedelics demonstrate efficacy in preventing cluster headaches.

AI reshapes pharmacy—see how stewardship, transparency, and training help pharmacists deploy tools safely, boost equity, and build trust.

This approval marks the first time patients can begin treatment with home administration either by themselves or their caregiver.

Like other HCPs, pharmacists use AI-driven tools to support the delivery of pharmacy-related services.

Pharmacist-driven discharge medication reconciliation services identifies clinical interventions and may contribute to a decreased 30-day readmission rate.

In an interview with Pharmacy Times, Deanna Horner, PharmD, BCPS, executive vice president of Eversona Enterprise Direct Strategy, discussed how payers, employers, and health plans can approach GLP-1 coverage as demand for these therapies continues to grow.

New real-world data suggest pharmacists may have an expanding role in prioritizing GLP-1 therapy for patients managing both conditions.

Physicians oversee prescription medications the patient is taking, but OTC products bypass this system, and patients are often unaware of what can and cannot be taken.

Kasey Malotte, PharmD, BCPS, discusses the new credential’s strengths and areas for growth as well as why a stronger training ecosystem is necessary for long-term impact.

Utah's AI-powered prescription refill pilot is fueling debate over how artificial intelligence can improve medication access and workflow efficiency while preserving the clinical oversight needed to ensure patient safety.