Six recent reports from the Digital NAFLD Summit 2021

Healio Gastroenterology and Hepatology presents the following report on recent stories from the Digital NAFLD Summit 2021.

These stories include research on nonalcoholic steatohepatitis, liver stiffness, novel metabolic dysfunction-associated fatty liver disease and more.

Pioglitazone safe, effective in NASH treatment

Pioglitazone was safe and effective in improving liver histology among patients with nonalcoholic steatohepatitis, according to a presenter at the Digital NAFLD Summit 2021.

“Fatty liver disease is the most prevalent liver disease globally and it’s of particular importance in Asia-Pacific due to the rapid westernization,” Jee-Fu Huang, of Kaohsiung Medical University Hospital, said. “Insulin resistance is the key player in NASH independent of obesity and visceral adiposity. The therapeutic efficacy and safety of pioglitazone (PGT), a PPARy agonist, deserves validation in Asian NASH patients.” Read more.

Icosabutate rapidly reduces biomarkers of liver injury in NASH

Two doses of icosabutate was well tolerated and safe in patients with nonalcoholic steatohepatitis.

During the Digital NAFLD Summit 2021, Stephen Harrison, MD, chief medical officer at Northsea Therapeutics, icosabutate’s manufacturer, presented the interim, 16-week results of the ICONA trial, an going 52-week, phase 2b study of 264 patients with NASH. Read more.

Researchers deem NAFLD a ‘public health priority’

Researchers developed a consensus statement that demonstrated the increased need for support in addressing nonalcoholic fatty liver disease as a global public health problem, according to a presentation at the Digital NAFLD Summit 2021.

Following a global NAFLD policy review in 2020 (Lazarus, et al. Nature Reviews Gastroenterol Hepatol, 2021), Jeffrey V. Lazarus, PhD, of the University of Barcelona and vice chair of EASL, and colleagues found, across 102 countries, none were well prepared to address NAFLD. Further, close to a third of countries received an overall score of zero in the domains of policy, guidelines, civil awareness, epidemiology, detection and management. Read more.

Longitudinal fat fraction, liver stiffness may signal rapid progression in NAFLD

The temporal change rate of proton density fat fraction and liver stiffness measurement are promising predictors for those at high risk for rapid clinical progression and may improve patient management in those with nonalcoholic fatty liver disease.

“From our observation, at the early fibrosis stages, the rate of change of liver stiffness measurement (LSM) is slow and positively correlated with the rate of change in proton-density fat fraction (delta PDFF),” Meng Yin, MD, of the Mayo Clinic, told Healio Gastroenterology. “At later fibrosis stages, the rate of change in LSM is higher and is negatively correlated with delta PDFF. Compared with other risk factors, the baseline value of LSM and the rate of change in PDFF were most strongly associated with subsequent change in LSM.” Read more.

Novel MAFLD criteria increases identification of fatty liver disease

Researchers identified more patients with fatty liver disease using novel metabolic dysfunction-associated fatty liver disease criteria compared with nonalcoholic fatty liver disease criteria.

“Fatty liver disease (FLD) has become the most common chronic liver disease globally with prevalence of over 25% and one of the major causes for cirrhosis and hepatocellular carcinoma,” Laurens van Kleef, MS, of Erasmus MC, University Medical Center, in Rotterdam, the Netherlands, said at the Digital NAFLD Summit 2021. “Recently, a transition from NAFLD to metabolic dysfunction-associated FLD (MAFLD) has been proposed to shift the focus to metabolic health. The novel definition requires the presence of metabolic dysfunction together with hepatic steatosis; this transition to MAFLD has not yet been studied extensively.” Read more.

Rare gene variants may increase risk for severe NAFLD in obesity

Severe nonalcoholic fatty liver disease may be correlated with Autophagy Related Gene 7 loss-of-function variants, which may impair hepatocellular ballooning and inflammation.

“We feel that the impaired ATG7 activity and autophagy are involved in pathogenesis of steatohepatitis in individuals with fatty liver disease,” Cristiana Bianco, MD, of the department of transfusion medicine and hematology at Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, in Milan, Italy, said at the Digital NAFLD Summit 2021. “Rare ATG7 variants are enriched in patients with severe and in particular loss-of-function variants associated with liver injury and hepatocellular carcinoma.” Read more.

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