Nonalcoholic Fatty Liver Disease

Healio presents the following report on the top 10 hepatology peer-tested articles from 2021.

To streamline and validate diagnosis of and clinical trials in non-alcoholic steatohepatitis, one group is on a mission to determine the best non-invasive tests for all physicians to use, according to a presentation.

This month’s cover story highlights the growing burden of hepatocellular carcinoma, the most common type of primary liver cancer, in the United States. Despite being a cancer that does not typically receive much attention, HCC is projected to become the third leading cause of cancer-related death in the United States by 2040 if current trends continue. Its increasing mortality is related to a growing number of cases in the setting of non-alcoholic fatty liver disease, the liver manifestation of the metabolic syndrome, and a high proportion of HCC cases being detected at a late stage. While patients detected at an early stage are amenable to curative therapies such as liver transplantation and have a median survival exceeding 5 years, those diagnosed at a late stage traditionally have had limited therapeutic options and a median survival of only 1 year.

Liver cancer — the fastest-growing cause of cancer death in the U.S. — has been notoriously difficult to treat.

About 25% of U.S. adults have nonalcoholic fatty liver disease, which is the most common chronic liver condition in the U.S., according to the American Liver Foundation.

This month’s cover story puts forth a call to action for our fellow physicians to be more aware of fatty liver disease risk. But this call needs to be about more than awareness. It must be a call for multidisciplinary coordinated screening and follow-up.

Among patients with nonalcoholic fatty liver disease, AXA1125 showed greater activity over 16 weeks compared with AXA1957 and placebo, according to a study published in The American Journal of Gastroenterology.

Among patients with FIB-4 nonalcoholic steatohepatitis at greater risk for progression to end stage liver disease, researchers at the International Liver Congress found efruxifermin 50 mg was safe and well-tolerated.

Two-year therapy with testosterone undecanoate normalized serum testosterone levels and reduced nonalcoholic fatty liver disease grade among men with obesity, functional hypogonadism and type 2 diabetes, data show.

Exercise provided considerable weight loss-independent benefits in patients with nonalcoholic fatty liver disease, according to research published in JHEP Reports.