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NAFLD simulator offers teaching tools, risk prediction

VIENNA — A new, open-access simulator gives providers the tools to show natural progression of non-alcoholic fatty liver disease to their patients using personalized factors, according to an expert at the International Liver Congress.

“We developed an open-access interactive tool for patients and providers that can help them understand such long-term risks. Also, the other objective is to increase awareness of NASH and its consequences in patients,” Jagpreet Chhatwal, PhD, from Massachusetts General Hospital, said during his presentation. “We wanted to create something open access, for people by people, and we can continue to modify this model as we begin to understand the natural history of NAFLD better and as we progress with making more treatments available, they can be added later on.”

Chhatwal and colleagues created a mathematical model that takes a subject’s personal characteristics such as age, sex and NAFLD stage to predict liver-related and non-liver-related mortality and cumulative risk for NAFLD progression as well as risk for developing decompensated cirrhosis and hepatocellular carcinoma.

Chhatwal showed how the simulator replicates the mortality curves and fibrosis progression seen in published studies.

“This is something that will be useful to inform what does it really mean if you treat or if patients regress from F4 to F3 stage or F3 to F2 stage. That will change liver-related mortality. Does it also change cardiovascular mortality? Possibly,” Chhatwal said.

The simulator generates organized reports showing the various risks of that individual. The site — www.nafldsimulator.org — also has awareness videos and other educational tools.

“This is ongoing work,” Chhatwal said. He said they would like to add in factors like diabetes, BMI, non-invasive fibrosis measurements and new treatments. – by Katrina Altersitz

Reference: Chhatwal J. PS-064. Presented at: International Liver Congress; April 10-14, 2019; Vienna, Austria.

Disclosures: Chhatwal has received research grants to his institution from Merck and Gilead and served as consultant to the World Health Organization, Department of Health and Human Services, Merck, Gilead, Complete HEOR Solutions and IQVIA.