fig1

Figure 1. Key Challenges in Designing Clinical Trials for MetALD. Trial design should consider the natural history and full spectrum of the disease, include assessment of cardiometabolic risk factors and alcohol use, address relevant legal regulations, clearly define clinical endpoints (e.g., mortality, liver-related events), and validate surrogate endpoints. Created in BioRender. Arab J. (2025) https://BioRender.com/dkn1f9j. FDA: Food and Drug Administration; EMA: European Medicines Agency; MRI-PDFF: magnetic resonance imaging-proton density fat fraction; ELF: enhanced liver fibrosis; MetALD: metabolic dysfunction-associated alcohol-related liver disease.