The burden of non-alcoholic steatohepatitis (NASH) among patients from Europe: A real-world patient-reported outcomes study

Balp, Maria‐Magdalena; Krieger, Nancy; Przybysz, Raymond; Way, Nate; Cai, Jennifer; Zappe, Dion H.; McKenna, Sarah Jane; Wall, G. E.; Janssens, Nico; Tapper, Elliot B.

doi:10.1016/j.jhepr.2019.05.009

Cited by 41 publications

(81 citation statements)

References 25 publications

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“…The cognitive and functional difficulties observed in NAFLD come with increased healthcare resources and profound societal implications including reduced quality of life and work productivity, need for care, and compliance with treatment regimens [ 157 ]. This represents a significant burden of illness and emphasizes the unmet needs of these patients, and thus, healthcare professionals should carefully consider the mental and physical quality of life of patients with NAFLD, even for those who do not have advanced liver disease.…”

Section: Clinical Considerations and Future Perspectivesmentioning

confidence: 99%

Cognitive Dysfunction in Non-Alcoholic Fatty Liver Disease—Current Knowledge, Mechanisms and Perspectives

Kjærgaard

Mikkelsen

Wernberg

et al. 2021

JCM

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Non-alcoholic fatty liver disease (NAFLD) has emerged as the hepatic component of the metabolic syndrome and now seemingly affects one-fourth of the world population. Features associated with NAFLD and the metabolic syndrome have frequently been linked to cognitive dysfunction, i.e. systemic inflammation, vascular dysfunction, and sleep apnoea. However, emerging evidence suggests that NAFLD may be a cause of cognitive dysfunction independent of these factors. NAFLD in addition exhibits dysbiosis of the gut microbiota and impaired urea cycle function, favouring systemic ammonia accumulation and further promotes systemic inflammation. Such disruption of the gut–liver–brain axis is essential in the pathogenesis of hepatic encephalopathy, the neuropsychiatric syndrome associated with progressive liver disease. Considering the growing burden of NAFLD, the morbidity from cognitive impairment is expected to have huge societal and economic impact. The present paper provides a review of the available evidence for cognitive dysfunction in NAFLD and outlines its possible mechanisms. Moreover, the clinical challenges of characterizing and diagnosing cognitive dysfunction in NAFLD are discussed.

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Section: Clinical Considerations and Future Perspectivesmentioning

confidence: 99%

Cognitive Dysfunction in Non-Alcoholic Fatty Liver Disease—Current Knowledge, Mechanisms and Perspectives

Kjærgaard

Mikkelsen

Wernberg

et al. 2021

JCM

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“…It is a spectrum of diseases comprising two distinct conditions: non-alcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH) [2]. The latter is a severe form in which the steatosis is accompanied by lobular in ammation and hepatocyte ballooning that can progress to liver brosis, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma (HCC) and other liver-related mortalities [3][4][5][6]. These are the causes of the mounting number of hospital admissions, which are likely to continue to increase every year.…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Economic Burden of Non-Alcoholic Steatohepatitis with Significant Fibrosis in Thailand

Phisalprapa

Prasitwarachot

Kositamongkol

et al. 2020

Preprint

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Background: Non-alcoholic steatohepatitis (NASH) has been recognised as a significant form of chronic liver disease and a common cause of cirrhosis and hepatocellular carcinoma, resulting in a considerable financial burden on healthcare resources. Currently, there is no information regarding the economic burden of NASH in low- and middle-income countries (LMICs). The aim of this study was to estimate the economic burden of NASH in Thailand as a lesson learned for LMICs.Methods: To estimate the healthcare costs and prevalence of NASH with significant fibrosis (fibrosis stage ≥ 2) in the general Thai population, an eleven-state lifetime horizon Markov model with 1-year cycle length was performed. The model comprised Thai population aged 18 years and older. The cohort size was based on Thailand Official Statistic Registration Systems. The incidence of NASH, transitional probabilities, and costs-of-illness were based on previously published literature, including systematic reviews and meta-analyses. The age-specific prevalence of NASH was based on Thai NASH registry data. Costs were expressed in 2019 US Dollars ($). As we undertook analysis from the payer perspective, only direct medical costs were included. All future costs were discounted at an annual rate of 3%. A series of sensitivity analyses were performed.Results: The estimated total number of patients with significant NASH was 2.9 million cases in 2019, based on a NASH prevalence of 5.74%. The total lifetime cost of significant NASH was $15.2 billion ($5,147 per case), representing approximately 3% of the 2019 GDP of Thailand. The probabilistic sensitivity analysis showed that the lifetime costs of significant NASH varied from $11.4 billion to $18.2 billion.Conclusions: The economic burden associated with NASH is substantial in Thailand. This prompts clinicians and policy makers to consider strategies for NASH prevention and management.

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“…It is a spectrum of diseases comprising two distinct conditions: non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH) [ 2 ]. The latter is a severe form in which the steatosis is accompanied by lobular inflammation and hepatocyte ballooning that can progress to liver fibrosis, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma (HCC), and other liver-related and non-liver related mortalities such as cardiovascular diseases [ 3 – 7 ]. These are the causes of the mounting number of hospital admissions, which are likely to continue to increase every year.…”

Section: Introductionmentioning

confidence: 99%

Economic burden of non-alcoholic steatohepatitis with significant fibrosis in Thailand

et al. 2021

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Background Non-alcoholic steatohepatitis (NASH) has been recognised as a significant form of chronic liver disease and a common cause of cirrhosis and hepatocellular carcinoma, resulting in a considerable financial burden on healthcare resources. Currently, there is no information regarding the economic burden of NASH in low- and middle-income countries (LMICs). The aim of this study was to estimate the economic burden of NASH in Thailand as a lesson learned for LMICs. Methods To estimate the healthcare costs and prevalence of NASH with significant fibrosis (fibrosis stage ≥ 2) in the general Thai population, an eleven-state lifetime horizon Markov model with 1-year cycle length was performed. The model comprised Thai population aged 18 years and older. The cohort size was based on Thailand Official Statistic Registration Systems. The incidence of NASH, transitional probabilities, and costs-of-illness were based on previously published literature, including systematic reviews and meta-analyses. The age-specific prevalence of NASH was based on Thai NASH registry data. Costs were expressed in 2019 US Dollars ($). As we undertook analysis from the payer perspective, only direct medical costs were included. All future costs were discounted at an annual rate of 3%. A series of sensitivity analyses were performed. Results The estimated total number of patients with significant NASH was 2.9 million cases in 2019, based on a NASH prevalence of 5.74%. The total lifetime cost of significant NASH was $15.2 billion ($5,147 per case), representing approximately 3% of the 2019 GDP of Thailand. The probabilistic sensitivity analysis showed that the lifetime costs of significant NASH varied from $11.4 billion to $18.2 billion. Conclusions The economic burden associated with NASH is substantial in Thailand. This prompts clinicians and policy makers to consider strategies for NASH prevention and management.

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The burden of non-alcoholic steatohepatitis (NASH) among patients from Europe: A real-world patient-reported outcomes study

Cited by 41 publications

References 25 publications

Cognitive Dysfunction in Non-Alcoholic Fatty Liver Disease—Current Knowledge, Mechanisms and Perspectives

Cognitive Dysfunction in Non-Alcoholic Fatty Liver Disease—Current Knowledge, Mechanisms and Perspectives

WITHDRAWN: Economic Burden of Non-Alcoholic Steatohepatitis with Significant Fibrosis in Thailand

Economic burden of non-alcoholic steatohepatitis with significant fibrosis in Thailand

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