A multisociety Delphi consensus statement on new fatty liver disease nomenclature

Journal of Hepatology, Journal Year: 2023, Volume and Issue: 79(6), P. 1542 - 1556

Published: June 24, 2023

The principal limitations of the terms NAFLD and NASH are reliance on exclusionary confounder use potentially stigmatising language. This study set out to determine if content experts patient advocates were in favour a change nomenclature and/or definition. A modified Delphi process was led by three large pan-national liver associations. consensus defined priori as supermajority (67%) vote. An independent committee external made final recommendation acronym its diagnostic criteria. total 236 panellists from 56 countries participated 4 online surveys 2 hybrid meetings. Response rates across survey rounds 87%, 83%, 78%, respectively. Seventy-four percent respondents felt that current sufficiently flawed consider name change. "nonalcoholic" "fatty" be 61% 66% respondents, Steatotic disease chosen an overarching term encompass various aetiologies steatosis. steatohepatitis important pathophysiological concept should retained. replace metabolic dysfunction-associated steatotic (MASLD). There definition include presence at least 1 5 cardiometabolic risk factors. Those with no parameters known cause deemed have cryptogenic disease. new category, outside pure disease, termed alcohol related/associated (MetALD), selected describe those who consume greater amounts per week (140-350 g/wk 210-420 for females males, respectively). criteria widely supported non-stigmatising, can improve awareness identification.

Language: Английский

A multisociety Delphi consensus statement on new fatty liver disease nomenclature

Hepatology, Journal Year: 2023, Volume and Issue: 78(6), P. 1966 - 1986

Published: June 22, 2023

The principal limitations of the terms NAFLD and NASH are reliance on exclusionary confounder use potentially stigmatising language. This study set out to determine if content experts patient advocates were in favor a change nomenclature and/or definition. A modified Delphi process was led by three large pan-national liver associations. consensus defined priori as supermajority (67%) vote. An independent committee external made final recommendation acronym its diagnostic criteria. total 236 panelists from 56 countries participated 4 online surveys 2 hybrid meetings. Response rates across survey rounds 87%, 83%, 78%, respectively. Seventy-four percent respondents felt that current sufficiently flawed consider name change. “nonalcoholic” “fatty” be 61% 66% respondents, Steatotic disease chosen an overarching term encompass various aetiologies steatosis. steatohepatitis important pathophysiological concept should retained. replace metabolic dysfunction–associated steatotic disease. There definition include presence at least 1 5 cardiometabolic risk factors. Those with no parameters known cause deemed have cryptogenic new category, outside pure disease, termed alcohol related/associated (MetALD), selected describe those who consume greater amounts per week (140–350 g/wk 210–420 for females males, respectively). criteria widely supported nonstigmatising, can improve awareness identification.

Language: Английский

A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis

New England Journal of Medicine, Journal Year: 2024, Volume and Issue: 390(6), P. 497 - 509

Published: Feb. 7, 2024

Nonalcoholic steatohepatitis (NASH) is a progressive liver disease with no approved treatment. Resmetirom an oral, liver-directed, thyroid hormone receptor beta–selective agonist in development for the treatment of NASH fibrosis. Download PDF Research Summary. We are conducting ongoing phase 3 trial involving adults biopsy-confirmed and fibrosis stage F1B, F2, or F3 (stages range from F0 [no fibrosis] to F4 [cirrhosis]). Patients were randomly assigned 1:1:1 ratio receive once-daily resmetirom at dose 80 mg 100 placebo. The two primary end points week 52 resolution (including reduction nonalcoholic fatty [NAFLD] activity score by ≥2 points; scores 0 8, higher indicating more severe disease) worsening fibrosis, improvement (reduction) least one NAFLD score. Overall, 966 patients formed analysis population (322 80-mg group, 323 100-mg 321 placebo group). was achieved 25.9% group 29.9% those as compared 9.7% (P<0.001 both comparisons placebo). Fibrosis 24.2% 14.2% change low-density lipoprotein cholesterol levels baseline 24 −13.6% −16.3% 0.1% Diarrhea nausea frequent than incidence serious adverse events similar across groups: 10.9% 12.7% 11.5% group. Both superior respect stage. (Funded Madrigal Pharmaceuticals; MAESTRO-NASH ClinicalTrials.gov number, NCT03900429.) QUICK TAKE VIDEO SUMMARYResmetirom Liver 02:17

Language: Английский

A multisociety Delphi consensus statement on new fatty liver disease nomenclature

Annals of Hepatology, Journal Year: 2023, Volume and Issue: 29(1), P. 101133 - 101133

Published: June 24, 2023

The principal limitations of the terms NAFLD and NASH are reliance on exclusionary confounder use potentially stigmatising language. This study set out to determine if content experts patient advocates were in favor a change nomenclature and/or definition. A modified Delphi process was led by three large pan-national liver associations. consensus defined priori as supermajority (67%) vote. An independent committee external made final recommendation acronym its diagnostic criteria. total 236 panelists from 56 countries participated 4 online surveys 2 hybrid meetings. Response rates across survey rounds 87%, 83%, 78%, respectively. Seventy-four percent respondents felt that current sufficiently flawed consider name change. "nonalcoholic" "fatty" be 61% 66% respondents, Steatotic disease chosen an overarching term encompass various aetiologies steatosis. steatohepatitis important pathophysiological concept should retained. replace metabolic dysfunction-associated steatotic disease. There definition include presence at least 1 5 cardiometabolic risk factors. Those with no parameters known cause deemed have cryptogenic new category, outside pure disease, termed alcohol related/associated (MetALD), selected describe those who consume greater amounts per week (140-350 g/wk 210-420 for females males, respectively). criteria widely supported nonstigmatising, can improve awareness identification.

Language: Английский

Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association

Circulation, Journal Year: 2023, Volume and Issue: 148(20), P. 1606 - 1635

Published: Oct. 9, 2023

Cardiovascular-kidney-metabolic health reflects the interplay among metabolic risk factors, chronic kidney disease, and cardiovascular system has profound impacts on morbidity mortality. There are multisystem consequences of poor cardiovascular-kidney-metabolic health, with most significant clinical impact being high associated incidence disease events is a prevalence in population, disproportionate burden seen those adverse social determinants health. However, there also growing number therapeutic options that favorably affect function, or both have cardioprotective effects. To improve related outcomes critical need for (1) more clarity definition syndrome; (2) an approach to staging promotes prevention across life course; (3) prediction algorithms include exposures relevant health; (4) strategies management relation reflect harmonization major subspecialty guidelines emerging scientific evidence. It incorporate considerations into care models syndrome reduce fragmentation by facilitating approaches patient-centered interdisciplinary care. This presidential advisory provides guidance definition, staging, paradigms, holistic patients details multicomponent vision effectively equitably enhancing population.

Language: Английский

EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD)

Journal of Hepatology, Journal Year: 2024, Volume and Issue: 81(3), P. 492 - 542

Published: June 7, 2024

Language: Английский

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A State-of-the-Art Review

Journal of Obesity & Metabolic Syndrome, Journal Year: 2023, Volume and Issue: 32(3), P. 197 - 213

Published: Sept. 13, 2023

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the latest term for associated with metabolic syndrome. MASLD most common cause of chronic and leading liver-related morbidity mortality. It important that all stakeholders be involved in tackling public health threat obesity obesity-related diseases, including MASLD. A simple clear assessment referral pathway using non-invasive tests essential to ensure patients severe are identified referred specialist care, while less remain primary where they best managed. While lifestyle intervention cornerstone management MASLD, cardiovascular risk must properly assessed managed because No pharmacological agent has been approved treatment but novel anti-hyperglycemic drugs appear have benefit. Medications used diabetes other conditions may need adjusted as progresses cirrhosis, especially decompensated cirrhosis. Based on tests, concepts compensated advanced clinically significant portal hypertension provide a practical approach stratifying according complications can help manage such patients. Finally, prevention sarcopenia should considered

Language: Английский

Randomized, Controlled Trial of the FGF21 Analogue Pegozafermin in NASH

New England Journal of Medicine, Journal Year: 2023, Volume and Issue: 389(11), P. 998 - 1008

Published: June 24, 2023

Pegozafermin is a long-acting glycopegylated (pegylated with the use of site-specific glycosyltransferases) fibroblast growth factor 21 (FGF21) analogue in development for treatment nonalcoholic steatohepatitis (NASH) and severe hypertriglyceridemia. The efficacy safety pegozafermin patients biopsy-proven noncirrhotic NASH are not well established.

Language: Английский

Tirzepatide for Metabolic Dysfunction–Associated Steatohepatitis with Liver Fibrosis

New England Journal of Medicine, Journal Year: 2024, Volume and Issue: 391(4), P. 299 - 310

Published: June 8, 2024

Metabolic dysfunction-associated steatohepatitis (MASH) is a progressive liver disease associated with liver-related complications and death. The efficacy safety of tirzepatide, an agonist the glucose-dependent insulinotropic polypeptide glucagon-like peptide-1 receptors, in patients MASH moderate or severe fibrosis unclear.

Language: Английский

4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes—2023

Diabetes Care, Journal Year: 2022, Volume and Issue: 46(Supplement_1), P. s49 - s67.2

Published: Dec. 12, 2022

The American Diabetes Association (ADA) “Standards of Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide components diabetes care, general treatment goals guidelines, tools evaluate quality care. Members ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating Standards annually, or more frequently as warranted. For detailed description standards, statements, reports, well evidence-grading system full list Committee members, please refer Introduction Methodology. Readers who wish comment on invited do so at professional.diabetes.org/SOC.

Language: Английский