S3-E55.3 – NIT Efficacy in Primary Care and Diabetes Clinic Settings

S3-E55.3 - NIT Efficacy in Primary Care and Diabetes Clinic Settings
A panel of seven attendees (Jörn Schattenberg, William Alazawi, Naim Alkhouri, Laurent Castera, Kenneth Cusi, Wayne Eskridge and Roger Green) convene to recap the just-concluded 2022 AASLD Liver Meeting. This conversation focuses around the efficacy of NITs for identifying fatty liver disease and progression in primary care and diabetes clinic settings.

Given the vast amount of information and insight from The Liver Meeting, this episode sought to identify and explore a few key highlights. The panel (Jörn Schattenberg, William Alazawi, Naim Alkhouri, Laurent Castera, Ken Cusi, Wayne Eskridge and Roger Green) addresses several topics from the program.

This conversation focuses on several papers of interest to Laurent. The first is a prospective screening study on patients with diabetes seen in either primary care or a diabetes clinic in the US. Using NITs to screen for NASH and MRE to screen for advanced disease, they identified 65% with NAFLD, 14% with advanced fibrosis and 5% with cirrhosis. When 164 of these patients moved into biopsy, they identified 61% with NAFLD, 30% advanced NASH and 9% cirrhosis. Laurent contrasts these results to a similar study conducted in a French diabetes clinic-treated cohort with transaminase greater than 20 in women and 30 in men. This yielded 58% NASH, 38% advanced fibrosis and 10% cirrhosis.

The panelists then explore the implications of both studies in terms of how screening should be conducted today. Laurent estimates that we might miss ~25% of advanced patients using current VCTE cutoffs without additional parameters. He also notes that neither duration of diabetes nor A1c levels were predictive. The group concludes that, as Ken puts it, studies like these push the needle toward action in both primary care and diabetes settings.

Categories:
Allied Health Professionals, Cirrhosis, Clinical Trials, Companies, Diabetes, Diagnostics, NITs, Doctors, Drugs/Drug Classes, Fatty Liver, FDA, Investors, Liver Science, Major Meetings, Metabolic Diseases, NAFLD, NASH, Obesity, Patients, Prevalence/Incidence, Public Health, Special Subpopulations

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