10 video highlights from 2018 hepatology meetings

Every year, Healio Gastroenterology and Liver Disease meets with hepatology and gastroenterology experts to discuss their presentations on the latest research data, therapeutic updates, and recent advocacy programs.

The following 10 exclusive video interviews from this year’s International Liver Congress, Digestive Disease Week, and The Liver Meeting include reports on autoimmune hepatitis, alcoholic hepatitis, hepatitis C and related opioid complications, nonalcoholic fatty liver disease, and liver cancer.

Obeticholic acid improved, stabilized fibrosis after incomplete response to UDCA

Most patients with primary biliary cholangitis who had an incomplete response to ursodeoxycholic acid achieved stabilization or regression of fibrosis after 3 years of treatment with obeticholic acid, according to a presentation at the International Liver Congress 2018.

“PBC, as you know, is an autoimmune liver disease which attacks the bile ducts and the liver and can lead to cirrhosis, liver failure and liver transplantation,” Christopher L. Bowlus, MD, from the University of California at Davis, Sacramento, told Healio Gastroenterology and Liver Disease. “Most patients are treated with ursodeoxycholic acid and many of them have a complete biochemical response, which essentially is normalization of their liver tests.” Watch here

Fecal microbiota transplant improves brain function in hepatic encephalopathy

Patients who underwent fecal microbiota transplant for recurrent hepatic encephalopathy had a lower risk for hospitalization and showed improve gut microbiome and brain function, according to this exclusive interview from the International Liver Congress 2018.

“These were patients ... who actually had multiple episodes of encephalopathy,” Jasmohan S. Bajaj, MD, from the Virginia Commonwealth University, told Healio Gastroenterology and Liver Disease. “We sought to treat the dysbiosis — which means the unbalanced gut microbiota — by a stool transplant from one donor. This one donor was selected to have the highest amount of the good bacteria.” Watch here

ELAD shows promise in alcoholic hepatitis biomechanical response

In a disease that has no current treatment, a plasma transfer system may offer hope to patients with alcoholic liver disease, according to a poster at the International Liver Congress 2018.

“It is unfortunate that patients with acute alcohol-induced decompensated liver disease are not able to be treated optimally,” Nikolaos T. Pyrsopoulos, MD, PhD, of Rutgers New Jersey Medical School, told Healio Gastroenterology and Liver Disease. “What we would consider our golden bullet — this means steroid-containing therapy — turned out to be not very optimal. In an attempt to against this fierce fight, the extracorporeal liver device might offer a very good result for a very highly specialized segment of this population.” Watch here

Women on HRT, birth control safely, effectively treated HCV with Zepatier

Though some direct-acting antivirals conflict with the administration of hormone replacement therapy or oral contraceptives, a recent study showed safety and efficacy with Zepatier, according to our exclusive interview with Christophe Hezode, MD, at the International Liver Congress 2018.

“It’s very important to check drug-drug interaction before starting treatment and we know that it’s very important to know that with ... Zepatier there is absolutely no drug-drug interactions between [oral contraceptive products (OCP)] and [hormone replacement therapy (HRT)],” Hezode, of Hopital Henri Mondor, Paris, France, told Healio Gastroenterology and Liver Disease. Watch here

Plasma assay of methylated DNA markers detects liver cancer

In this exclusive video perspective from Digestive Disease Week 2018, John B. Kisiel, MD, a gastroenterologist from the Mayo Clinic in Rochester, Minn., shares results of a study in which plasma assay of methylated DNA markers detected hepatocellular carcinoma across all stages.

“These are markers we discovered as part of a larger set in an experiment that sequenced DNA extracted from frozen tissue specimens from patients at Mayo Clinic,” Kisiel told Healio Gastroenterology and Liver Disease. “The aim of the present study was to validate these markers in a larger cohort that included a spectrum of stages of disease, including early-stage patients who would be potentially curable.” Watch here

HCV outcomes worse for patients with public insurance, Medicaid

In this exclusive video perspective from Digestive Disease Week 2018, Zobair M. Younossi, MD, chairman of the department of medicine at Inova Fairfax Hospital in Virginia, discusses insurance coverage and mortality in patients with hepatitis C in the U.S.

“Patients with hepatitis C have different demographics ... and certain ethnic groups, as well as those that are uninsured. When you look at the type of insurance patients with hepatitis C have, they were more uninsured and had higher rates of public insurance than private,” Younossi told Healio Gastroenterology and Liver Disease. Watch here

Expert reviews clinical liver disease take-aways from DDW 2018

In this exclusive video perspective from Digestive Disease Week 2018, Steven L. Flamm, MD, chief of the Liver Program at Northwestern University Feinberg School of Medicine in Illinois, reviews some of the important clinical presentations in liver disease from the meeting.

“As usual, there are presentations across the gamut of liver disease at DDW,” Flamm told Healio Gastroenterology and Liver Disease. “They include the topics of hepatitis B, hepatitis C, autoimmune hepatitis, liver cancer, liver transplantation and many other pertinent topics to your practice.” Watch here

Opioid use more common in chronic liver disease than other chronic diseases

In this exclusive video perspective from The Liver Meeting 2018, Monica Konerman, MD, director of the Michigan Medicine NAFLD Clinic, discusses results of a study that found opioid use to be twice as common among patients with chronic liver disease compared with other common chronic diseases.

“We were very interested to try and figure out what the overall prevalence of opioid use is in patients with chronic liver disease because right now we know that there is an opioid epidemic, but we don’t really have good data in terms of how many patients with chronic liver disease are actually using prescription opioids,” Konerman told Healio Gastroenterology and Liver Disease. Watch here

New NAFLD data guide treatment, improve survival

In this exclusive video perspective from The Liver Meeting 2018, Zobair M. Younossi, MD, chairman of the department of medicine at Inova Fairfax Hospital in Virginia, discusses several presentations on patient reported-outcomes and mortality related to nonalcoholic fatty liver disease and nonalcoholic steatohepatitis.

“Nonalcoholic fatty liver disease in general has three important impacts or burden, which I call comprehensive burden of nonalcoholic fatty liver disease: there’s clinical ... related to mortality and complications of cirrhosis; there’s patient-reported outcome, which is a surrogate for patient experience; and there is also research utilization,” Younossi told Healio Gastroenterology and Liver Disease. Watch here

PSC Partners announce new ICD code for primary sclerosing cholangitis

In this exclusive video perspective from The Liver Meeting 2018, leaders of the PSC Partners organization announce a newly approved ICD-10 code for primary sclerosing cholangitis.

“Here at The Liver Meeting, we are running the beginning of an educational campaign where we’re trying to reach providers, researchers and patients to remind everybody to start using the new code for PSC patients,” Ricky Safer, CEO of PSC Partners, told Healio Gastroenterology and Liver Disease. Watch here

Every year, Healio Gastroenterology and Liver Disease meets with hepatology and gastroenterology experts to discuss their presentations on the latest research data, therapeutic updates, and recent advocacy programs.

The following 10 exclusive video interviews from this year’s International Liver Congress, Digestive Disease Week, and The Liver Meeting include reports on autoimmune hepatitis, alcoholic hepatitis, hepatitis C and related opioid complications, nonalcoholic fatty liver disease, and liver cancer.

Obeticholic acid improved, stabilized fibrosis after incomplete response to UDCA

Most patients with primary biliary cholangitis who had an incomplete response to ursodeoxycholic acid achieved stabilization or regression of fibrosis after 3 years of treatment with obeticholic acid, according to a presentation at the International Liver Congress 2018.

“PBC, as you know, is an autoimmune liver disease which attacks the bile ducts and the liver and can lead to cirrhosis, liver failure and liver transplantation,” Christopher L. Bowlus, MD, from the University of California at Davis, Sacramento, told Healio Gastroenterology and Liver Disease. “Most patients are treated with ursodeoxycholic acid and many of them have a complete biochemical response, which essentially is normalization of their liver tests.” Watch here

Fecal microbiota transplant improves brain function in hepatic encephalopathy

Patients who underwent fecal microbiota transplant for recurrent hepatic encephalopathy had a lower risk for hospitalization and showed improve gut microbiome and brain function, according to this exclusive interview from the International Liver Congress 2018.

“These were patients ... who actually had multiple episodes of encephalopathy,” Jasmohan S. Bajaj, MD, from the Virginia Commonwealth University, told Healio Gastroenterology and Liver Disease. “We sought to treat the dysbiosis — which means the unbalanced gut microbiota — by a stool transplant from one donor. This one donor was selected to have the highest amount of the good bacteria.” Watch here

ELAD shows promise in alcoholic hepatitis biomechanical response

In a disease that has no current treatment, a plasma transfer system may offer hope to patients with alcoholic liver disease, according to a poster at the International Liver Congress 2018.

“It is unfortunate that patients with acute alcohol-induced decompensated liver disease are not able to be treated optimally,” Nikolaos T. Pyrsopoulos, MD, PhD, of Rutgers New Jersey Medical School, told Healio Gastroenterology and Liver Disease. “What we would consider our golden bullet — this means steroid-containing therapy — turned out to be not very optimal. In an attempt to against this fierce fight, the extracorporeal liver device might offer a very good result for a very highly specialized segment of this population.” Watch here

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Women on HRT, birth control safely, effectively treated HCV with Zepatier

Though some direct-acting antivirals conflict with the administration of hormone replacement therapy or oral contraceptives, a recent study showed safety and efficacy with Zepatier, according to our exclusive interview with Christophe Hezode, MD, at the International Liver Congress 2018.

“It’s very important to check drug-drug interaction before starting treatment and we know that it’s very important to know that with ... Zepatier there is absolutely no drug-drug interactions between [oral contraceptive products (OCP)] and [hormone replacement therapy (HRT)],” Hezode, of Hopital Henri Mondor, Paris, France, told Healio Gastroenterology and Liver Disease. Watch here

Plasma assay of methylated DNA markers detects liver cancer

In this exclusive video perspective from Digestive Disease Week 2018, John B. Kisiel, MD, a gastroenterologist from the Mayo Clinic in Rochester, Minn., shares results of a study in which plasma assay of methylated DNA markers detected hepatocellular carcinoma across all stages.

“These are markers we discovered as part of a larger set in an experiment that sequenced DNA extracted from frozen tissue specimens from patients at Mayo Clinic,” Kisiel told Healio Gastroenterology and Liver Disease. “The aim of the present study was to validate these markers in a larger cohort that included a spectrum of stages of disease, including early-stage patients who would be potentially curable.” Watch here

HCV outcomes worse for patients with public insurance, Medicaid

In this exclusive video perspective from Digestive Disease Week 2018, Zobair M. Younossi, MD, chairman of the department of medicine at Inova Fairfax Hospital in Virginia, discusses insurance coverage and mortality in patients with hepatitis C in the U.S.

“Patients with hepatitis C have different demographics ... and certain ethnic groups, as well as those that are uninsured. When you look at the type of insurance patients with hepatitis C have, they were more uninsured and had higher rates of public insurance than private,” Younossi told Healio Gastroenterology and Liver Disease. Watch here

Expert reviews clinical liver disease take-aways from DDW 2018

In this exclusive video perspective from Digestive Disease Week 2018, Steven L. Flamm, MD, chief of the Liver Program at Northwestern University Feinberg School of Medicine in Illinois, reviews some of the important clinical presentations in liver disease from the meeting.

“As usual, there are presentations across the gamut of liver disease at DDW,” Flamm told Healio Gastroenterology and Liver Disease. “They include the topics of hepatitis B, hepatitis C, autoimmune hepatitis, liver cancer, liver transplantation and many other pertinent topics to your practice.” Watch here

PAGE BREAK

Opioid use more common in chronic liver disease than other chronic diseases

In this exclusive video perspective from The Liver Meeting 2018, Monica Konerman, MD, director of the Michigan Medicine NAFLD Clinic, discusses results of a study that found opioid use to be twice as common among patients with chronic liver disease compared with other common chronic diseases.

“We were very interested to try and figure out what the overall prevalence of opioid use is in patients with chronic liver disease because right now we know that there is an opioid epidemic, but we don’t really have good data in terms of how many patients with chronic liver disease are actually using prescription opioids,” Konerman told Healio Gastroenterology and Liver Disease. Watch here

New NAFLD data guide treatment, improve survival

In this exclusive video perspective from The Liver Meeting 2018, Zobair M. Younossi, MD, chairman of the department of medicine at Inova Fairfax Hospital in Virginia, discusses several presentations on patient reported-outcomes and mortality related to nonalcoholic fatty liver disease and nonalcoholic steatohepatitis.

“Nonalcoholic fatty liver disease in general has three important impacts or burden, which I call comprehensive burden of nonalcoholic fatty liver disease: there’s clinical ... related to mortality and complications of cirrhosis; there’s patient-reported outcome, which is a surrogate for patient experience; and there is also research utilization,” Younossi told Healio Gastroenterology and Liver Disease. Watch here

PSC Partners announce new ICD code for primary sclerosing cholangitis

In this exclusive video perspective from The Liver Meeting 2018, leaders of the PSC Partners organization announce a newly approved ICD-10 code for primary sclerosing cholangitis.

“Here at The Liver Meeting, we are running the beginning of an educational campaign where we’re trying to reach providers, researchers and patients to remind everybody to start using the new code for PSC patients,” Ricky Safer, CEO of PSC Partners, told Healio Gastroenterology and Liver Disease. Watch here