After a simple opening from Roger Green, this conversation includes 4 key elements:
1:24 – Arun Sanyal discusses directions that Fatty Liver policy in India is heading, along with some its unique features (for example, focus on rural health)
2:58 – Louise Campbell discusses the gap between how the best British programs (as identified in Jeff Lazarus’s paper) organize and operate as compared to what the recent British Liver Trust study tells us about overall Fatty Liver care in the U.K. After Roger makes a commitment to return to health services policy in future episodes, Louise asks a question about how high screen fail rates appear to be in this study. Stephen Harrison notes that these are not particularly high for a NAFLD or NASH study and explains why.
7:28 – Roger asks his final question, which is how panelists believe FGF 21s will be used 5-7 years from today. Arun Sanyal provides the first answer, which looks at FGF-21s and NASH in the context of metabolic diseases and discusses how GLP-1 and SGLT-2 agents that were originally indicated solely for Type 2 Diabetes have broadened indications and use by demonstrating benefit in related non-communicable metabolic diseases,
10:05 – The other panelists add smaller points to Arun’s exceptional and global statement. Stephen concurs completely with one important addition: If FGF-21s demonstrate potent anti-fibrotic effects in NASH patients, this will give them a unique role in first-line therapy. Louise follows up with her belief that uptake of these agents might mimic some of the Hep C drug and Roger concludes by saying that the entire range of FGF effects is not widely known and, as a result, it is difficult to predict how widespread use might be.