Next week, >10,000 Fatty Liver stakeholders are expected to journey to London (rail strike and all) for the International Liver Congress (#ILC2022), the first meeting at this level since the pandemic started to include an in-person attendance option. This week, NASH Tsunami identifies some of the most important and intriguing non-embargoed presentations at #ILC2022. This conversation explores two of these: FRI 100, Shear wave elastography, transient elastography and enhanced liver fibrosis test use in the assessment of NAFLD in real-world practices, from Zobair Younossi (US); and OS044, NAFLD patients have worse health-related QoL compared to the general population irrespective of their fibrosis stage: results from a prospective multicenter UK study, from Margarita Papatheodoridi (UK). In the middle, the Surfers briefly discuss why the balance of papers discussed in this episode tilts so strongly toward real-world data and large databases.
Highlighting Intriguing ILC2022 Abstracts: Elastography and the Importance of NAFLD Quality-of-Life Metrics
Louise starts this conversation by bridging from her discussion of FRI094 to another poster (FRI100) that assesses the real-world value of three different techniques for assessing NAFLD levels. She shares the paper in the context of this year’s papers tilting heavily toward real-world data. In this case, the researchers utilized a database of over 13,000 respondents, reduced the size down to ~4,000 with FIB-4>1.46, and then attempted to stage patients using Electronic Health Record data and elastography (shear wave of VCTE). The paper concluded that the combination of these measures in EHR provided excellent guidance in staging without having to resort to special blood tests on the first round.
The conversation shifts briefly into the issue of how the pandemic slowed clinical drug development trials. Stephen shares his experience on where trials slowed down the most to support the idea that the pandemic is the factor driving a lower number of drug development papers and to say that this will increase in the years ahead.
From here, Roger begins his discussion of OS044, a prospective study over 561 UK patients exploring associations of fibrosis severity and metabolic comorbidities with QoL score levels. The pivotal finding of the abstract is that there is a clear significant difference between patients with and without NAFLD, and another clear difference between cirrhotic and non-cirrhotic NAFLD patients, but no significant difference between patients with NAFLD and pre-cirrhotic NASH. Roger comments that this is important for two reasons: it attests to the logic of Global Liver Institute’s #StopNASHNow slogan for International NASH Day, and it strengthens the case for making Quality-of-Life an endpoint in clinical trials. Jörn comments on the rigor of the design and speculates on the degree to which diabetes might underlie these findings. Stephen closes the conversation by focusing on the importance of physicians checking patients’ quality-of-life as part of their screening and regular visits, hard as it might be to find the time to ask.