On November 4th-8th in Washington DC, as many as 10,000 attendees will convene in an effort to advance and disseminate the science and practice of hepatology, and to promote liver health and quality patient care.
Part 2: A Preview of the 2022 AASLD Liver Meeting
Mazen begins by highlighting a presentation by Laurent Castera which covers an abstract the two collaborated on. The paper looks to validate and compare head-to-head the FASTTM, MAST, and MEFIB scores as well as FIB-4 and NAFLD fibrosis score in a large cohort of T2D patients with NAFLD. Roger notes last week’s discussion on use of FIB-4 as a primary screening tool, commending its performance in NPV but not PPV. He suggests this study offers a way forward for an enriched population who would benefit from a test offering high PPV and a narrow indeterminate zone. Jörn and Louise respond with their thoughts on FIB-4 as a cheap, accessible tool for primary care. Their analysis aligns with a conclusion from last week’s preview: FIB-4 is not a tool for the specialist’s office but, instead for primary care practices conducting first-line screening.
Ian suggests some of the preceding conversation anchors performance of these tests to biopsy. Interested in moving beyond biopsy, he points out presentations which compare outcomes of patients according to either biopsy or associated noninvasive tests. The first paper investigates whether screening for advanced fibrosis in the community can identify the subgroup of people with NAFLD at higher risk for development of liver-related complications. The study aimed to determine the prognostic value of baseline noninvasive fibrosis tests for predicting liver-related outcomes and mortality in patients with NAFLD from T2D clinics or primary care. Ian then looks at a presentation by Samer Gawrieh which provides data on progression. Mazen agrees with the idea that as data accumulates around NITs, we can better understand how longitudinal changes impact outcomes.
Jörn highlights his anticipation for Parallel 12: NASH therapeutics and OMICs. He specifically points to a presentation by Jonathan Stine on answering an unmet need to develop effective lifestyle intervention programs. This randomized proof of concept trial evaluates the feasibility, acceptability and safety of a novel commercially available mobile health app. This topic immediately resonates with Jeff, who is encouraged by two elements: the development of remote personalized technologies and the resulting patient empowerment. Roger raises questions around the commercial model buttressing this study: who is paying and for how long can they maintain motivation? He envisions a more viable approach will be supported by commercial payers, who in return are investing in health care data. Given this may take some time to play out, Roger casts a third suggestion: FDA-approved digital therapeutic apps. He predicts this to be fertile grounds for patient empowerment over the next few years. After some back and forth with Jeff, Roger shifts focus to his interest in posters on primary care screening and the metabolic-NAFLD link. Mazen shares his enthusiasm for the potential of machine learning to ensure accuracy in the use of NITs.
As time winds down, the panelists provide closing comments touching on a number of topics. It’s noted that this data-rich, insight-laden conference will host a dynamic inclusion of presentations on therapeutics, drug development and solutions deployed to market. Stay tuned for the upcoming live recorded coverage from Washington DC.
