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Fatty liver highlights from The Liver Meeting 2018

This year at The Liver Meeting, several researchers presented data on recent advances in clinical therapeutics for nonalcoholic fatty liver disease and nonalcoholic steatohepatitis, as well as data on increasing incidence trends and discussions on the need for improved awareness.

The following reports include presentations on a thyroid receptor agonist for NASH, expert reviews on the current and upcoming clinical landscape of NAFLD therapy, and updated information on NGM282 for NASH.

Thyroid receptor agonist shows sustained response in NASH

A novel thyroid receptor agonist — MGL-3196 — showed a sustained reduction in liver fat and other markers of nonalcoholic steatohepatitis in a 36-week study, according to data presented at The Liver Meeting 2018.

“Ultimately, we saw sustained statistically significant reduction in liver fat on MRI-PDFF compared with placebo, sustained statistically significant lowering of multiple atherogenic lipids including as well as statistically significant lowering and normalization of serum liver transferases and, overall, well tolerated and safe,” Stephen A. Harrison, MD, of the University of Oxford, said during his presentation. “There was statistically significant resolution of NASH that is correlated with reduction in liver fat on MRI-PDFF and we believe this provides evidence to move forward to a registrational phase 3 trial.” Read more

VIDEO: New NAFLD data guide treatment, improve survival

In this exclusive video perspective from The Liver Meeting 2018, Zobair M. Younossi, MD, chairman of the department of medicine at Inova Fairfax Hospital in Virginia, discusses several presentations on patient reported-outcomes and mortality related to nonalcoholic fatty liver disease and nonalcoholic steatohepatitis.

“Nonalcoholic fatty liver disease in general has three important impacts or burden, which I call comprehensive burden of nonalcoholic fatty liver disease: there’s clinical ... related to mortality and complications of cirrhosis; there’s patient-reported outcome, which is a surrogate for patient experience; and there is also research utilization,” Younossi told Healio Gastroenterology and Liver Disease. Read more

Fatty liver expert: ‘We face a moral, ethical and medical imperative’

Beyond finding a “cure” to nonalcoholic fatty liver disease, one expert at The Liver Meeting 2018 called on physicians and governments alike to fight the root cause of the disease.

“While progress is being made to control liver outcomes, this is only a band aid,” Arun Sanyal, MD, of Virginia Commonwealth University, said during the Leon Schiff State-of-the-Art Lecture. “We face a moral, ethical and medical imperative to tackle the root cause of diabetes, cardiovascular disease and NASH — ie, diet-induced obesity.” Read more

Aramchol reduces liver fat, improves histology in NASH

Results from a phase 2b trial showed that Aramchol— a stearoyl coenzyme desaturase A inhibitor — significantly reduced liver fat and improved histology with excellent safety and tolerability in patients with nonalcoholic fatty liver disease, according to data presented at The Liver Meeting 2018.

“Aramchol is a novel, first in class SCD1 modulator, targeted to the liver to reduce liver fat and collagen production,” Vlad Ratziu, MD, from Sorbonne University in France, said in his presentation. “In 1 year of study, Aramchol showed liver fat reduction, biochemical improvement, NASH resolution and fibrosis reduction in a dose response pattern.” Read more

Thyroid receptor agonist improves fatty liver in 91% of patients

VK2809, a thyroid receptor beta agonist, showed an impact on nearly all treated patients as measured by magnetic resonance imaging-proton density fat fraction, according to late breaking data presented at The Liver Meeting 2018.

“Up to 91% of individuals had a significant improvement in liver fat by the criteria of 30% or more in MRI-PDFF reduction,” Rohit Loomba, MD, of the University of California San Diego, said during his Late Breaker presentation. “Planning for subsequent study with biopsy-confirmed NASH is underway.” Read more

NGM282 shows equivalent efficacy in NASH at lower dose

Although previously reported effective at a 3 mg dose, NGM282 showed similar efficacy in treating nonalcoholic steatohepatitis at 1 mg, according to data presented at The Liver Meeting 2018.

“NGM282 demonstrates improvement across histologic and noninvasive endpoints in NASH. There’s potent target engagement with C4 suppression and bile acids. There are significant meaningful reductions across all noninvasive markers of NASH-related disease. And, ultimately, we see unprecedented antifibrotic activity at week 12 with both the 1 mg and 3 mg dose,” Stephen A. Harrison, MD, of University of Oxford, said during his presentation. Read more

'Mounting concern' over fatty liver as costs increase 86% over 10 years

Over 10 years, from 2005 to 2014, the number of patients with a diagnosis of nonalcoholic fatty liver disease increased by 260% and costs jumping 86%, according to data presented at The Liver Meeting 2018.

“Nonalcoholic fatty liver disease presents a mounting concern in the United States due to the increasing cost of care, length of stay and mortality rate,” Shil Patel, MD, gastroenterology fellow at CarePoint Health Medical Center, said during his presentation. “Despite medical advances in the treatment of obesity, diabetes and other related comorbidities, NAFLD continues to be a serious health problem.” Read more