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Baseline liver enzyme assessment is reasonable for patients with: Pre-existing liver disease or elevated baseline transaminases Metabolic syndrome or clinical features suggesting MASLD Concurrent use of other potentially hepatotoxic medications Obesity (BMI 30 kg/m) with additional metabolic risk factors History of excessive alcohol consumption For patients with abnormal baseline liver enzymes, periodic monitoring every 3-6 months during the first year of therapy allows clinicians to assess treatment response and detect any unexpected changes