Model predicts a 23% increase in MASLD prevalence from 2020 to 2050

Key takeaways:

• Metabolic dysfunction-associated steatotic liver disease was predicted to affect 34.4% of U.S. adults by 2050.
• The model also predicted increases in liver cancer and liver transplantation.

BOSTON — A new model forecasted a “substantial clinical burden” of metabolic dysfunction-associated steatotic liver disease in the next 30 years, including twice as many cases of liver cancer and triple the need for liver transplantation.

“The prevalence of NAFLD has been increasing significantly both worldwide and in the U.S.,” Phuc Le, PhD, MPH, assistant professor of medicine at Cleveland Clinic Lerner College of Medicine, said at The Liver Meeting media briefing. “A recent meta-analysis estimated that 38% of U.S. adults had NAFLD in 2019. ... A better understanding of the clinical burden, especially the size of the treatment targeted population, will help our health systems to prepare for the growing clinical demand.”

To estimate the projected disease burden among U.S. adults from 2020 to 2050, Le and colleagues developed a mathematical model that simulated growth of the U.S. population and tracked the natural history of NAFLD, now known as MASLD.

“Model inputs were derived from the literature and unknown inputs were calibrated and validated against published estimates,” Le noted.

According to Le, the model predicted a 23% increase in MASLD prevalence, affecting 27.6% of the U.S. adult population, or 72 million people, in 2020 and rising to 34%, or 109 million, in 2050. Among these patients, metabolic dysfunction-associated steatohepatitis, or MASH, was projected to increase from 20% to 21.8%, respectively.

Further, the model predicted the prevalence of fibrosis (≥ stage 2) would increase from 16.3 million people in 2020 to 25 million in 2050, and the population with MASH and fibrosis (≥ stage 2) would increase 1.5 times from 6.4 million to 9.8 million. Cirrhosis and liver-related deaths were projected to increase from 1.9% and 0.4%, respectively, to 3.1% and 1%.

Le also reported that by 2050, new cases of hepatocellular carcinoma are projected to double from 10,400 to an estimated 19,300 and new LTs will nearly triple from 1,700 to 4,200.

“Our model forecasts a substantial clinical burden of NAFLD over the next three decades,” Le concluded. “In the absence of effective treatments, health systems should plan for large increases in the number of liver cancer cases and the need for liver transplant.”