S4 – E50.1 – Wrapping up 2023 in Steatotic Liver Disease: A Discussion with Jeff Lazarus

S4 - E50.1 - Wrapping up 2023 in Steatotic Liver Disease: A Discussion with Jeff Lazarus
Surfing the MASH Tsunami kicks off its 2023 wrap-up conversations with Jeff Lazarus, the 2023 winner of the Distinguished Scientific Achievement Award from the American Liver Foundation. Wrapping up 2023 in Steatotic Liver Disease: A Discussion with Jeff Lazarus

Surfing the MASH Tsunami kicks off its 2023 wrap-up conversations with Jeff Lazarus, the 2023 winner of the Distinguished Scientific Achievement Award from the American Liver Foundation. He discusses three core MASLD-related opportunities for which he played a key role 2023: the Research in Action initiative, the new MASLD nomenclature process and the Healthy Livers, Healthy Lives coalition.

Most of this discussion focuses on Jeff’s work to for and lead the Research in Action coalition. As Jeff notes, this was the first time the MASLD “field has set its own agenda.” Absent governmental or not-for-profit agencies driving the discussion, a group that has grown to over 400 collaborators published its own action agenda in AASLD and EASL publications. Jeff discusses the process through which he built this consensus, focusing on domains identified in earlier meetings: (i) treatment and care; (ii) models of care; (lll) increased awareness; and (iv) leadership. Jeff feels the legitimacy of this activity comes from “casting the net wide” with a series of Wilton Park meetings and from demonstrating how far MASLD lagged behind other non-communicable diseases in terms of goal development, structured support and public presence. Another key element in the initiative’s success was side event at the World Health Assembly led by the four major hepatology organizations, including not only AASLD and EASL but also APASL, ALEH. Efforts to create parity with other non-communicable diseases will result in increased fund and “massive” increases in awareness.

Today, the other NCDs mention other related metabolic diseasess, but not MASLD or MASH. Another example of the lack of urgency around MASLD: NIH just put out a call for funding for HIV, which Jeff notes might not be as high a priority in 2024 as MASLD.

At this point, Jörn Schattenberg joins the conversation to congratulate Jeff on his recognition and award and also to discuss how important it is to the entire community that Jeff plays the role he does. In response, Jeff comments that one benefit of the Award is that it ratifies the importance of the kinds of consensus building and amplication of public health initiatves in MASLD space.

From here, Jeff and Jörn step further forward to discuss the importance of funding prevention and education programs, done by governments in the EU and perhaps public or private players in the US. Jörn discusses the multidisciplinary nature of the Barcelona meeting they co-chair and how it provides outreach beyond hepatology. Jeff continues the thought to discuss the importance of social determinants of health (for example, food insecurity) in a world where healthy foods cost far more than more common alternatives (basmati rice costs 3x basic white rice).

Roger asks how the new nomenclature is proceeding. Jeff says it is doing quite well in that there is significant global buy-in. Major centers around the world are adopting the new nomenclature for their meetings and clinics, but, Jeff notes, it is difficult for physicians to explain the disease to patients without using the words “fat” or “fatty.”

As the conversation winds up, Jeff notes the importance of bring primary care to the education and outreach processes and the goal of doubling the number of patients screened over the next four year. The conversation closes on this note: much to do, much that must be done, but confidence that the energy and passion to achieve these big goals is coalescing properly.