Patients with nonalcoholic fatty liver disease could undergo SteatoTest, ActiTest and FibroTest, due to their close association with steatosis, inflammatory activity and fibrosis scores, according to research published in Alimentary Pharmacology & Therapeutics.
“This study for the first time used as histological reference a simple classification of the three elementary features which are important for estimating the severity of this disease,” Thierry Poynard, PhD, professor in the hepato-gastroenterology department at Groupe Hospitalier Pitié-Salpêtrière in Paris, France, told Healio.com/Hepatology. “If the tests show significant fibrosis or significant activity, these cases must be followed up with a hepatologist to prevent cirrhosis and primary liver cancer.”
Poynard and colleagues studied 600 patients who recently had bloodwork and biopsies and were likely to have NAFLD. Their nonbinary-receiver operating characteristic (NonBinAUROC) and fibrosis blood test comparisons were used as endpoints to avoid repetitive testing and spectrum effects.
The mean NonBinAUROCs of tests were all signiﬁcant: 0.878 (95% CI, 0.864–0.892) for FibroTest and ﬁbrosis stages, 0.846 (95% CI, 0.83–0.862) for ActiTest and activity grades, and 0.822 (95% CI, 0.804– 0.84) for SteatoTest and steatosis grades. FibroTest had a higher NonBinAUROC than BARD (0.836; 95% CI, 0.82–0.852; P = .0001), fibrosis-4 (FIB-4) (0.845; 0.829–0.861; P = .007) but not signiﬁcantly different than NAFLD scores. FibroTest had a signiﬁcant difference in median values between adjacent stage F2 and stage F1 as opposed to BARD, FIB-4 and NAFLD scores.
Poynard told Healio.com/Hepatology that “FibroTest, SteatoTest and ActiTest were also extensively validated in patients with chronic viral hepatitis C, but less validated in patients with metabolic factors — arterial hypertension, dyslipidemia, overweight and diabetes — who are at greater likelihood of significant fibrosis, steatosis and necro-inflammatory histological activity.”
“The aim of the present study was not to claim for a near perfect panel of [noninvasive tests (NITs)], but to conﬁrm the signiﬁcant performances of these tests in non-NAFLD patient,” researchers wrote. “Our aim was in line with the recommendations of scientiﬁc societies such as EASL. In patients with presumed NAFLD, we improved the validation of NITs already recommended for viral hepatitis.”
Poynard told Healio.com/Hepatology the SteatoTest, ActiTest and FibroTest are available in the United States under NASH-FibroSure. – by Janel Miller
Disclosure: Poynard reports he is the inventor of the SteatoTest, ActiTest and FibroTest and holds a capital interest in BioPredictive, the company marketing the tests. Healio.com/Hepatology was unable to determine relevant financial disclosures of the other researchers at the time of publication.