EASL Congress 2023 rewind: What you may have missed; alcohol use, NASH data top agenda
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EASL Congress 2023 has ended but, as the society’s official media partner, Healio was at the forefront covering the latest in liver disease. Wondering what you may have missed? Healio recaps the biggest news disrupting the specialty.
Healio covered a range of presentations from the EASL Congress with the hot topics being alcohol-related liver disease and nonalcoholic steatohepatitis. The research significantly focused on treatment options for alcohol related liver disease and its impact on disease progression as well as the many treatment options being explored for NASH.
Additionally, we covered research on a home-based prehabilitation program for liver transplantation and the increased risk for intracerebral hemorrhage in patients with hepatitis B virus infection.
In case you missed it, here is a list Healio compiled of the top meeting coverage from EASL Congress.
Naltrexone achieves abstinence, reduces lapses in patients with alcohol use disorder
Naltrexone was effective in achieving abstinence, reducing lapses and improving craving scores at 3 months in patients with alcohol-related cirrhosis, according to data presented at EASL Congress.
“In the largest randomized controlled trial available to date, which is a combined trial with 1,380 patients with alcohol use disorder, naltrexone has been shown to have an increased incidence of abstinence and also reduced heavy drinking days,” Manasa Alla, MD, of the Institute of Liver and Biliary Sciences in New Delhi, said. Read more.
Risk for alcohol-related hospitalization fourfold higher in offspring of parents with ALD
Children of parents with alcohol-related liver disease had up to a more than fourfold increased risk for alcohol-related hospitalization, despite a low absolute risk for developing alcohol-related liver disease.
“Patients with alcohol-related liver disease have on average been drinking heavily for 10 to 20 years before they are diagnosed, in which time they might raise children,” Gro Askgaard, MD, a clinical researcher in the department of hepatology and gastroenterology at Aarhus University Hospital in Denmark, said at EASL Congress. “Being exposed to parental alcohol abuse may increase the risk of alcohol abuse disorder for these offspring. In addition, these offspring may also have a genetic susceptibility to develop alcohol-related liver disease if they drink hazardously.” Read more.
Nearly 15% of patients with alcohol-related liver disease progress to decompensation
Among patients with alcoholic-related liver disease in early stages, 15% progressed to decompensation and 22% died within 6 years, according to data presented at EASL Congress.
“Despite [alcohol-related liver disease] being highly prevalent, it is still largely under studied and overlooked as a research area,” Stine Johansen, MBBS, from the Odense University Hospital in Denmark, told attendees. “It is important to study the natural history of disease, as this information will help us improve diagnostic and treatment strategies and also help inform public health strategies and guidelines.” Read more.
Endoscopic sleeve gastroplasty an effective option for patients with NASH, obesity
Endoscopic sleeve gastroplasty was more effective for weight loss than lifestyle modification alone in patients with nonalcoholic steatohepatitis and obesity, according to a speaker at EASL Congress.
“Previous studies show how lifestyle intervention with a reduction of more than 10% of body weight promotes NASH resolution and fibrosis regression,” Javier Abad Guerra, MD, a gastroenterology and hepatology specialist at Puerta de Hierro Majadahonda University Hospital, said. “Unfortunately, less than 10% of the patients achieved this goal with only diet and exercise. In recent years, endoscopic bariatric and metabolic therapies have emerged as safe and effective options to promote weight loss in obesity patients.” Read more.
Home-based program with incentives, daily text reminders boosts activity in LT candidates
A home-based, prehabilitation program for liver transplant candidates that included financial incentives and text reminders increased walking by one-third over baseline, according to data presented at EASL Congress.
“We wanted to test the feasibility and acceptability of a home-based, pragmatic patient-randomized program among liver transplant candidates at a single liver transplant center,” Marina Serper, MD, MS, assistant professor of gastroenterology and hepatology at the University of Pennsylvania, said during her presentation. “Our inclusion criteria was age of 21 or older and having a MELD score of less than or equal to 25. We did not want to take patients with very high MELD scores who would be too ill to exercise. Patients had to be on the active liver transplant waitlist or on the pre-waitlist list that we have at the University of Pennsylvania.” Read more.
Pegozafermin improves fibrosis, shows promise as ‘mainstay treatment’ for NASH
Pegozafermin significantly improved fibrosis without worsening of nonalcoholic steatohepatitis, and vice versa, with similar efficacy reported at weekly and biweekly dosing intervals, according to late-breaker data at EASL Congress.
“As a physician, I know how important it is to provide patients with therapies that can be impactful across a broad population of individuals with NASH, especially ones that can easily blend into their daily lives,” Rohit Loomba, MD, MHSc, professor of medicine and chief of the division of gastroenterology and hepatology at University of California San Diego School of Medicine, said in a related 89bio press release. “It’s both incredibly encouraging and exciting to see the positive, consistent results from this research across all aspects — efficacy, safety, tolerability and dosing convenience.” Read more.
Chronic HBV infection linked to increased risk for intracerebral hemorrhage
Chronic hepatitis B virus infection was significantly associated with an increased risk for intracerebral hemorrhage but not other types of stroke in Chinese adults, according to data presented at the EASL Congress.
“China has the greatest burden of hepatitis B in the world,” Elizabeth Hamilton, a DPhil candidate in the Nuffield Department of Population Health at the University of Oxford, said. “One in three people with chronic hepatitis B reside in China and it’s estimated that about 10 million people living with chronic hepatitis B in China today will die by the year 2030, mostly from avoidable liver cancers.” Read more.
Resmetirom achieves ‘meaningful effects’ on NASH resolution, fibrosis stage improvement
Both 80 mg and 100 mg doses of resmetirom achieved liver biopsy endpoints at 52 weeks in patients with nonalcoholic steatohepatitis and had a safety profile consistent with previous reports, according to primary MAESTRO-NASH trial results.
“Resmetirom is an oral, once-daily liver-targeted [thyroid hormone receptor]-beta- selective agonist in development for NASH,” Stephen A. Harrison, MD, FAASLD, from Pinnacle Clinical Research in San Antonio,” said during a presentation at EASL Congress. “In the presence of lipotoxicity, hepatic thyroid function mediated by THR beta is disrupted, impacting lipoprotein metabolism as well as fatty acid oxidation in the liver.” Read more.