PROs of Patient-reported Outcomes for Nonalcoholic Fatty Liver Disease and Effects on Treatment for Nonalcoholic Steatohepatitis

Balakrishnan, Maya; Loomba, Rohit

doi:10.1016/j.cgh.2019.04.018

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…Political commitment and concerted actions of the multiple stakeholders involved in prevention and treatment should be mandatory, but very few European countries have so far defined policies to tackle NAFLD in the community 196. The proactive involvement of patients’ associations is highly recommended to include patient reported outcomes among relevant targets of future large scale randomized and observational studies 197198…”

Section: Discussionmentioning

confidence: 99%

Management of non-alcoholic fatty liver disease

Petroni

Brodosi

Bugianesi

et al. 2021

BMJ

127

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Non-alcoholic fatty liver disease is a very common medical condition, driven by a combination of genetic and lifestyle factors, ultimately producing a severe chronic liver disease and increased cardiovascular risk. Most people are asymptomatic for a long time, and their daily life is unaffected, leading to difficulty in identifying and managing people who slowly progress to non-alcoholic steatohepatitis (NASH), NASH-cirrhosis, and eventually hepatocellular carcinoma. Despite advances in the understanding of pathogenic mechanisms and the identification of liver fibrosis as the strongest factor in predicting disease progression, no specific treatments have been approved by regulatory agencies. Outside controlled trials, treatment is generally limited to lifestyle intervention aimed at weight loss. Pioglitazone remains the drug of choice to reduce progression of fibrosis in people with diabetes, although it is often used off-label in the absence of diabetes. Vitamin E is mainly used in children and may be considered in adults without diabetes. Several drugs are under investigation according to the agreed targets of reduced NASH activity without worsening of fibrosis or improving fibrosis without worsening of NASH. Anti-inflammatory, anti-fibrotic agents and metabolism modulators have been tested in either phase III or phase IIb randomized controlled trials; a few failed, and others have produced marginally positive results, but only a few are being tested in extension studies. The development of non-invasive, easily repeatable surrogate biomarkers and/or imaging tools is crucial to facilitate clinical studies and limit liver biopsy.

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Section: Discussionmentioning

confidence: 99%

Management of non-alcoholic fatty liver disease

Petroni

Brodosi

Bugianesi

et al. 2021

BMJ

127

View full text Add to dashboard Cite

show abstract

“…Although NAFLD is generally believed to be clinically silent and asymptomatic until its later stages, nonspecific complaints and presentations (e.g., fatigue, pruritus, abdominal discomfort, right upper quadrant pain, anxiety) are not uncommon. Consequently, PROs—reflecting patients' perspective on the impact of NAFLD on their lives and how the disease is experienced208—are becoming increasingly important contributors to clinical management decisions. Growing evidence indicates that health‐related quality of life (HRQL) is negatively affected by NAFLD 209–212.…”

Section: Nafld In Special Groupsmentioning

confidence: 99%

Geographical similarity and differences in the burden and genetic predisposition of NAFLD

et al. 2022

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NAFLD has become a major public health problem for more than 2 decades with a growing prevalence in parallel with the epidemic of obesity and type 2 diabetes (T2D). The disease burden of NAFLD differs across geographical regions and ethnicities. Variations in prevalence of metabolic diseases, extent of urban–rural divide, dietary habits, lifestyles, and the prevalence of NAFLD risk and protective alleles can contribute to such differences. The rise in NAFLD has led to a remarkable increase in the number of cases of cirrhosis, hepatocellular carcinoma, hepatic decompensation, and liver‐related mortality related to NAFLD. Moreover, NAFLD is associated with multiple extrahepatic manifestations. Most of them are risk factors for the progression of liver fibrosis and thus worsen the prognosis of NAFLD. All these comorbidities and complications affect the quality of life in subjects with NAFLD. Given the huge and growing size of the population with NAFLD, it is expected that patients, healthcare systems, and the economy will suffer from the ongoing burden related to NAFLD. In this review, we examine the disease burden of NAFLD across geographical areas and ethnicities, together with the distribution of some well‐known genetic variants for NAFLD. We also describe some special populations including patients with T2D, lean patients, the pediatric population, and patients with concomitant liver diseases. We discuss extrahepatic outcomes, patient‐reported outcomes, and economic burden related to NAFLD.

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“…As the authors note in their discussion, quality of life instruments should be considered in managing patients with NAFLD as they may highlight subtle symptoms that influence patient well-being and also potentially identify patients who may benefit from treatment. Also, see the accompanying editorial by Maya Balakrishnan and Rohit Loomba 14 and related article by Younossi ZM,et al 15 See page 2085.…”

Section: Clopidogrel Andmentioning

confidence: 99%

Issue Highlights

Gellad

2019

Clinical Gastroenterology and Hepatology

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PROs of Patient-reported Outcomes for Nonalcoholic Fatty Liver Disease and Effects on Treatment for Nonalcoholic Steatohepatitis

Cited by 5 publications

References 20 publications

Management of non-alcoholic fatty liver disease

Management of non-alcoholic fatty liver disease

Geographical similarity and differences in the burden and genetic predisposition of NAFLD

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