This week attendees from around the world convened at the 73rd Annual AASLD Liver Meeting for a lively and momentous event in Washington DC. On the final morning, Stephen Harrison, Sven Francque, Jörn Schattenberg, Ian Rowe and Jeff McIntyre join Roger Green to discuss key takeaways.
Sven is first to expand on a presentation that struck notable interest. He chooses to highlight a presentation by Laurent Castera, which Mazen Noureddin anticipated in our preview coverage. This focuses on a prospective head-to-head comparison of the different non-invasive tests in a large cohort of T2D patients with NAFLD. The paper concluded that F-AST and MAST scores outperformed MEFIB, FIB-4 and NFS for identifying fibrotic NASH in T2D patients with NAFLD. Stephen broadens Sven’s analysis by noting F-AST as a standout test that is generally available for multiple different applications. The group puts forth commentary on the cost effectiveness and accuracy of these tests within enriched populations. As this subject winds down, Ian points to the particular challenge of selecting patients for treatment. The reality, he says, is that it’s not a one size fits all approach.
The conversation transitions from diagnostics to the topic of drugs. Stephen walks through his presentation on the efficacy and safety of Akero’s lead product candidate efruxifermin (EFX) in patients with clinically relevant NASH (F2-F3). The results point to EFX significantly improving liver histology, liver fat content and noninvasive markers of liver injury, fibrosis, and glucose and lipid metabolism in patients with F2/F3 fibrosis due to NASH. Stephen shares his optimism for this particular FGF-21 agonist while Sven agrees that “not all FGF-21’s are created equal.” The group explores the science behind the structure of the EFX compound before Roger recalls the question of where the right use for such a drug might exist. It’s been previously suggested on this podcast that a medication not entirely suited for long-term therapy due to cost, dosing or side effects might serve best as induction therapy. With this in mind, the group addresses the dynamics of what happens when disease regresses to a point where there is far less liver damage. From here, Roger introduces a brief assessment of Arun Sanyal’s presentation of topline results from a new analysis of the REGENERATE Trial.
The last major theme in this episode involves the Nomenclature session. Jeff offers an objective account of how this subject reported before disclosing some concerns from the patient perspective. His primary concern lies in coming to a decision that causes regulatory agencies to require new clinical trials, thereby slowing approvals by several years. The other panelists respond with their impressions and the consensus is that virtually nobody is in favor of a name change at this point in time if it stands in the way of progressing drugs and diagnostics.
The breadth, quality and novelty of this conversation reflects yet another exceptional and positive Liver Meeting, this time back in person.
In lieu of the typical business report, Roger and Stephen conduct a special interview with Michael Cooreman from Inventiva. The three discuss the work of this clinical-stage biopharmaceutical company and its relevance to Fatty Liver. Inventiva develops novel and differentiated oral small molecule therapies for patients suffering from diseases with significant unmet medical need. The discussion centers mostly around clinical trial development for the pan-PPAR lanifibranor.