VIDEO: New NAFLD data guide treatment, improve survival
SAN FRANCISCO — 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.
In one study presented at the meeting, Younossi and colleagues found that among patients with hepatocellular carcinoma on Medicare, the only cancer etiology associated with increased mortality was NAFLD.
Results from two studies looking at four patient-reported outcome instruments showed that patients with NASH experienced severe impairment of quality of life, especially as fibrosis increased from stage 3 to stage 4.
Details from a poster presentation showed that noninvasive tests, such as the NAFLD fibrosis score (NFS) and the Enhanced Liver Fibrosis (ELF) tool, demonstrated acceptable diagnostic performance for the discrimination of advanced fibrosis due to NASH.
Finally, Younossi shared data from a study of different treatment strategies for patients with NASH. Study results showed that continual treatment of NASH rather than cessation after 2 years led to a significant increase in the proportion of surviving patients. These results, he explained, suggest that treatment of NASH should be similar to treatment of metabolic comorbidities like diabetes rather than treatment for viral hepatitis.
“A lot of our patients with nonalcoholic steatohepatitis will require long-term treatment. If you do this, you’ve improved the stage of fibrosis and you’re able to maintain that improvement, lives and the economic benefit of that could be substantial.” – by Talitha Bennett
Younossi ZM, et al. Abstracts 0179, 0273, 1674, 1991. Presented at: The Liver Meeting 2018; Nov. 9-13, 2018; San Francisco.
Disclosure: Younossi reports financial connections with Bristol-Myers Squibb, Gilead, Intercept, NovoNordisk and Shinogi.