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1. A global action agenda for turning the tide on fatty liver disease

Author

Lazarus, J, Mark, H, Allen, A, Arab, J, Carrieri, P, Noureddin, M, Alazawi, W, Alkhouri, N, Alqahtani, S, Anstee, Q, Arrese, M, Bataller, R, Berg, T, Brennan, P, Burra, P, Castro-Narro, G, Cortez-Pinto, H, Cusi, K, Dedes, N, Duseja, A, Francque, S, Gastaldelli, A, Hagström, H, Huang, T, Ivancovsky Wajcman, D, Kautz, A, Kopka, C, Krag, A, Newsome, P, Rinella, M, Romero, D, Sarin, S, Silva, M, Spearman, C, Terrault, N, Tsochatzis, E, Valenti, L, Villota-Rivas, M, Zelber-Sagi, S, Schattenberg, J, Wong, V, Younossi, Z, Perseghin, G, Lazarus, Jeffrey V, Mark, Henry E, Allen, Alina M, Arab, Juan Pablo, Carrieri, Patrizia, Noureddin, Mazen, Alazawi, William, Alkhouri, Naim, Alqahtani, Saleh A, Anstee, Quentin M, Arrese, Marco, Bataller, Ramon, Berg, Thomas, Brennan, Paul N, Burra, Patrizia, Castro-Narro, Graciela E, Cortez-Pinto, Helena, Cusi, Kenneth, Dedes, Nikos, Duseja, Ajay, Francque, Sven M, Gastaldelli, Amalia, Hagström, Hannes, Huang, Terry T K, Ivancovsky Wajcman, Dana, Kautz, Achim, Kopka, Christopher J, Krag, Aleksander, Newsome, Philip N, Rinella, Mary E, Romero, Diana, Sarin, Shiv Kumar, Silva, Marcelo, Spearman, C Wendy, Terrault, Norah A, Tsochatzis, Emmanuel A, Valenti, Luca, Villota-Rivas, Marcela, Zelber-Sagi, Shira, Schattenberg, Jörn M, Wong, Vincent Wai-Sun, Younossi, Zobair M, Perseghin, Gianluca, Lazarus, J, Mark, H, Allen, A, Arab, J, Carrieri, P, Noureddin, M, Alazawi, W, Alkhouri, N, Alqahtani, S, Anstee, Q, Arrese, M, Bataller, R, Berg, T, Brennan, P, Burra, P, Castro-Narro, G, Cortez-Pinto, H, Cusi, K, Dedes, N, Duseja, A, Francque, S, Gastaldelli, A, Hagström, H, Huang, T, Ivancovsky Wajcman, D, Kautz, A, Kopka, C, Krag, A, Newsome, P, Rinella, M, Romero, D, Sarin, S, Silva, M, Spearman, C, Terrault, N, Tsochatzis, E, Valenti, L, Villota-Rivas, M, Zelber-Sagi, S, Schattenberg, J, Wong, V, Younossi, Z, Perseghin, G, Lazarus, Jeffrey V, Mark, Henry E, Allen, Alina M, Arab, Juan Pablo, Carrieri, Patrizia, Noureddin, Mazen, Alazawi, William, Alkhouri, Naim, Alqahtani, Saleh A, Anstee, Quentin M, Arrese, Marco, Bataller, Ramon, Berg, Thomas, Brennan, Paul N, Burra, Patrizia, Castro-Narro, Graciela E, Cortez-Pinto, Helena, Cusi, Kenneth, Dedes, Nikos, Duseja, Ajay, Francque, Sven M, Gastaldelli, Amalia, Hagström, Hannes, Huang, Terry T K, Ivancovsky Wajcman, Dana, Kautz, Achim, Kopka, Christopher J, Krag, Aleksander, Newsome, Philip N, Rinella, Mary E, Romero, Diana, Sarin, Shiv Kumar, Silva, Marcelo, Spearman, C Wendy, Terrault, Norah A, Tsochatzis, Emmanuel A, Valenti, Luca, Villota-Rivas, Marcela, Zelber-Sagi, Shira, Schattenberg, Jörn M, Wong, Vincent Wai-Sun, Younossi, Zobair M, and Perseghin, Gianluca

Abstract

Background and Aims: Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care. Approach and Results: We developed an aligned, prioritized action agenda for the global fatty liver disease community of practice. Following a Delphi methodology over 2 rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the action priorities using Qualtrics XM, indicating agreement using a 4-point Likert-scale and providing written feedback. Priorities were revised between rounds, and in R2, panelists also ranked the priorities within 6 domains: epidemiology, treatment and care, models of care, education and awareness, patient and community perspectives, and leadership and public health policy. The consensus fatty liver disease action agenda encompasses 29 priorities. In R2, the mean percentage of “agree” responses was 82.4%, with all individual priorities having at least a super-majority of agreement (> 66.7% “agree”). The highest-ranked action priorities included collaboration between liver specialists and primary care doctors on early diagnosis, action to address the needs of people living with multiple morbidities, and the incorporation of fatty liver disease into relevant non-communicable disease strategies and guidance. Conclusions: This consensus-driven multidisciplinary fatty liver disease action agenda developed by care providers, clinical researchers, and public health and policy experts provides a path to reduce fatty liver disease prevalence and improve health outcomes. To implement this agenda, concerted efforts will be needed at the global, regional, and national levels.

Published
2024

4. A global research priority agenda to advance public health responses to fatty liver disease

Author

Lazarus, J, Mark, H, Allen, A, Arab, J, Carrieri, P, Noureddin, M, Alazawi, W, Alkhouri, N, Alqahtani, S, Arrese, M, Bataller, R, Berg, T, Brennan, P, Burra, P, Castro-Narro, G, Cortez-Pinto, H, Cusi, K, Dedes, N, Duseja, A, Francque, S, Hagstrom, H, Huang, T, Wajcman, D, Kautz, A, Kopka, C, Krag, A, Miller, V, Newsome, P, Rinella, M, Romero, D, Sarin, S, Silva, M, Spearman, C, Tsochatzis, E, Valenti, L, Villota-Rivas, M, Zelber-Sagi, S, Schattenberg, J, Wong, V, Younossi, Z, Aberg, F, Adams, L, Al-Naamani, K, Albadawy, R, Alexa, Z, Allison, M, Alnaser, F, Alswat, K, Alvares-da-Silva, M, Alvaro, D, Alves-Bezerra, M, Andrade, R, Anstee, Q, Awuku, Y, Baatarkhuu, O, Baffy, G, Bakieva, S, Bansal, M, Barouki, R, Batterham, R, Behling, C, Belfort-DeAguiar, R, Berzigotti, A, Betel, M, Bianco, C, Bosi, E, Boursier, J, Brunt, E, Bugianesi, E, Byrne, C, Cabrera Cabrejos, M, Caldwell, S, Carr, R, Castellanos Fernandez, M, Castera, L, Castillo-Lopez, M, Caussy, C, Cerda-Reyes, E, Ceriello, A, Chan, W, Chang, Y, Charatcharoenwitthaya, P, Chavez-Tapia, N, Chung, R, Colombo, M, Coppell, K, Cotrim, H, Craxi, A, Crespo, J, Dassanayake, A, Davidson, N, De Knegt, R, de Ledinghen, V, Demir, M, Desalegn, H, Diago, M, Dillon, J, Dimmig, B, Dirac, M, Dirchwolf, M, Dufour, J, Dvorak, K, Ekstedt, M, El-Kassas, M, Elsanousi, O, Elsharkawy, A, Elwakil, R, Eskridge, W, Eslam, M, Esmat, G, Fan, J, Ferraz, M, Flisiak, R, Fortin, D, Fouad, Y, Freidman, S, Fuchs, M, Gadano, A, Gastaldelli, A, Geerts, A, Geier, A, George, J, Gerber, L, Ghazinyan, H, Gheorghe, L, Kile, D, Girala, M, Boon Bee, G, Goossens, N, Graupera, I, Gronbaek, H, Hamid, S, Hebditch, V, Henry, Z, Hickman, I, Hobbs, L, Hocking, S, Hofmann, W, Idilman, R, Iruzubieta, P, Isaacs, S, Isakov, V, Ismail, M, Jamal, M, Jarvis, H, Jepsen, P, Jornayvaz, F, Sudhamshu, K, Kakizaki, S, Karpen, S, Kawaguchi, T, Keating, S, Khader, Y, Kim, S, Kim, W, Kleiner, D, Koek, G, Joseph Komas, N, Kondili, L, Koot, B, Korenjak, M, Kotsiliti, E, Koulla, Y, Kugelmas, C, Kugelmas, M, Labidi, A, Lange, N, Lavine, J, Lazo, M, Leite, N, Lin, H, Lkhagvaa, U, Long, M, Lopez-Jaramillo, P, Lozano, A, Macedo, M, Malekzadeh, R, Marchesini, G, Marciano, S, Martinez, K, Martinez Vazquez, S, Mateva, L, Mato, J, Nlombi, C, Mccary, A, Mcintyre, J, Mckee, M, Mendive, J, Mikolasevic, I, Miller, P, Milovanovic, T, Milton, T, Moreno-Alcantar, R, Morgan, T, Motala, A, Muris, J, Musso, C, Nava-Gonzalez, E, Negro, F, Nersesov, A, Neuschwander-Tetri, B, Nikolova, D, Norris, S, Novak, K, Ocama, P, Ong, J, Ong-Go, A, Onyekwere, C, Padilla, M, Pais, R, Pan, C, Panduro, A, Panigrahi, M, Papatheodoridis, G, Paruk, I, Patel, K, Goncalves, C, Figueroa, M, Perez-Escobar, J, Pericas, J, Perseghin, G, Pessoa, M, Petta, S, Marques Souza de Oliveira, C, Prabhakaran, D, Pyrsopoulous, N, Rabiee, A, Ramji, A, Ratziu, V, Ravendhran, N, Ray, K, Roden, M, Romeo, S, Romero-Gomez, M, Rotman, Y, Rouabhia, S, Rowe, I, Sadirova, S, Alkhatry, M, Salupere, R, Satapathy, S, Schwimmer, J, Sebastiani, G, Seim, L, Seki, Y, Serme, A, Shapiro, D, Sharvadze, L, Shaw, J, Shawa, I, Shenoy, T, Shibolet, O, Shimakawa, Y, Shubrook, J, Singh, S, Sinkala, E, Skladany, L, Skrypnyk, I, Song, M, Sookoian, S, Sridharan, K, Stefan, N, Stine, J, Stratakis, N, Sheriff, D, Sundaram, S, Svegliati-Baroni, G, Swain, M, Tacke, F, Taheri, S, Tan, S, Tapper, E, Targher, G, Tcaciuc, E, Thiele, M, Tiniakos, D, Tolmane, I, Torre, A, Torres, E, Treeprasertsuk, S, Trenell, M, Turcan, S, Turcanu, A, Valantinas, J, van Kleef, L, Velarde Ruiz Velasco, J, Vesterhus, M, Vilar-Gomez, E, Waked, I, Wattacheril, J, Wedemeyer, H, Wilkins, F, Willemse, J, Wong, R, Yilmaz, Y, Yki-Jarvinen, H, Yu, M, Yumuk, V, Zeybel, M, Zheng, K, Zheng, M, Lazarus J. V., Mark H. E., Allen A. M., Arab J. P., Carrieri P., Noureddin M., Alazawi W., Alkhouri N., Alqahtani S. A., Arrese M., Bataller R., Berg T., Brennan P. N., Burra P., Castro-Narro G. E., Cortez-Pinto H., Cusi K., Dedes N., Duseja A., Francque S. M., Hagstrom H., Huang T. T. -K., Wajcman D. I., Kautz A., Kopka C. J., Krag A., Miller V., Newsome P. N., Rinella M. E., Romero D., Sarin S. K., Silva M., Spearman C. W., Tsochatzis E. A., Valenti L., Villota-Rivas M., Zelber-Sagi S., Schattenberg J. M., Wong V. W. -S., Younossi Z. M., Aberg F., Adams L., Al-Naamani K., Albadawy R. M., Alexa Z., Allison M., Alnaser F. A., Alswat K., Alvares-da-Silva M. R., Alvaro D., Alves-Bezerra M., Andrade R. J., Anstee Q. M., Awuku Y. A., Baatarkhuu O., Baffy G., Bakieva S., Bansal M. B., Barouki R., Batterham R. L., Behling C., Belfort-DeAguiar R., Berzigotti A., Betel M., Bianco C., Bosi E., Boursier J., Brunt E. M., Bugianesi E., Byrne C. J., Cabrera Cabrejos M. C., Caldwell S., Carr R., Castellanos Fernandez M. I., Castera L., Castillo-Lopez M. G., Caussy C., Cerda-Reyes E., Ceriello A., Chan W. -K., Chang Y., Charatcharoenwitthaya P., Chavez-Tapia N., Chung R. T., Colombo M., Coppell K., Cotrim H. P., Craxi A., Crespo J., Dassanayake A., Davidson N. O., De Knegt R., de Ledinghen V., Demir M., Desalegn H., Diago M., Dillon J. F., Dimmig B., Dirac M. A., Dirchwolf M., Dufour J. -F., Dvorak K., Ekstedt M., El-Kassas M., Elsanousi O. M., Elsharkawy A. M., Elwakil R., Eskridge W., Eslam M., Esmat G., Fan J. -G., Ferraz M. L., Flisiak R., Fortin D., Fouad Y., Freidman S. L., Fuchs M., Gadano A., Gastaldelli A., Geerts A., Geier A., George J., Gerber L. H., Ghazinyan H., Gheorghe L., Kile D. G., Girala M., Boon Bee G. G., Goossens N., Graupera I., Gronbaek H., Hamid S., Hebditch V., Henry Z., Hickman I. J., Hobbs L. A., Hocking S. L., Hofmann W. P., Idilman R., Iruzubieta P., Isaacs S., Isakov V. A., Ismail M. H., Jamal M. H., Jarvis H., Jepsen P., Jornayvaz F., Sudhamshu K. C., Kakizaki S., Karpen S., Kawaguchi T., Keating S. E., Khader Y., Kim S. U., Kim W., Kleiner D. E., Koek G., Joseph Komas N. P., Kondili L. A., Koot B. G., Korenjak M., Kotsiliti E., Koulla Y., Kugelmas C., Kugelmas M., Labidi A., Lange N. F., Lavine J. E., Lazo M., Leite N., Lin H. -C., Lkhagvaa U., Long M. T., Lopez-Jaramillo P., Lozano A., Macedo M. P., Malekzadeh R., Marchesini G., Marciano S., Martinez K., Martinez Vazquez S. E., Mateva L., Mato J. M., Nlombi C. M., McCary A. G., McIntyre J., McKee M., Mendive J. M., Mikolasevic I., Miller P. S., Milovanovic T., Milton T., Moreno-Alcantar R., Morgan T. R., Motala A., Muris J., Musso C., Nava-Gonzalez E. J., Negro F., Nersesov A. V., Neuschwander-Tetri B. A., Nikolova D., Norris S., Novak K., Ocama P., Ong J. P., Ong-Go A., Onyekwere C., Padilla M., Pais R., Pan C., Panduro A., Panigrahi M. K., Papatheodoridis G., Paruk I., Patel K., Goncalves C. P., Figueroa M. P., Perez-Escobar J., Pericas J. M., Perseghin G., Pessoa M. G., Petta S., Marques Souza de Oliveira C. P., Prabhakaran D., Pyrsopoulous N., Rabiee A., Ramji A., Ratziu V., Ravendhran N., Ray K., Roden M., Romeo S., Romero-Gomez M., Rotman Y., Rouabhia S., Rowe I. A., Sadirova S., Alkhatry M. S., Salupere R., Satapathy S. K., Schwimmer J. B., Sebastiani G., Seim L., Seki Y., Serme A. K., Shapiro D., Sharvadze L., Shaw J. E., Shawa I. T., Shenoy T., Shibolet O., Shimakawa Y., Shubrook J. H., Singh S. P., Sinkala E., Skladany L., Skrypnyk I., Song M. J., Sookoian S., Sridharan K., Stefan N., Stine J. G., Stratakis N., Sheriff D. S., Sundaram S. S., Svegliati-Baroni G., Swain M. G., Tacke F., Taheri S., Tan S. -S., Tapper E. B., Targher G., Tcaciuc E., Thiele M., Tiniakos D., Tolmane I., Torre A., Torres E. A., Treeprasertsuk S., Trenell M., Turcan S., Turcanu A., Valantinas J., van Kleef L. A., Velarde Ruiz Velasco J. A., Vesterhus M., Vilar-Gomez E., Waked I., Wattacheril J., Wedemeyer H., Wilkins F., Willemse J., Wong R. J., Yilmaz Y., Yki-Jarvinen H., Yu M. -L., Yumuk V., Zeybel M., Zheng K. I., Zheng M. -H., Lazarus, J, Mark, H, Allen, A, Arab, J, Carrieri, P, Noureddin, M, Alazawi, W, Alkhouri, N, Alqahtani, S, Arrese, M, Bataller, R, Berg, T, Brennan, P, Burra, P, Castro-Narro, G, Cortez-Pinto, H, Cusi, K, Dedes, N, Duseja, A, Francque, S, Hagstrom, H, Huang, T, Wajcman, D, Kautz, A, Kopka, C, Krag, A, Miller, V, Newsome, P, Rinella, M, Romero, D, Sarin, S, Silva, M, Spearman, C, Tsochatzis, E, Valenti, L, Villota-Rivas, M, Zelber-Sagi, S, Schattenberg, J, Wong, V, Younossi, Z, Aberg, F, Adams, L, Al-Naamani, K, Albadawy, R, Alexa, Z, Allison, M, Alnaser, F, Alswat, K, Alvares-da-Silva, M, Alvaro, D, Alves-Bezerra, M, Andrade, R, Anstee, Q, Awuku, Y, Baatarkhuu, O, Baffy, G, Bakieva, S, Bansal, M, Barouki, R, Batterham, R, Behling, C, Belfort-DeAguiar, R, Berzigotti, A, Betel, M, Bianco, C, Bosi, E, Boursier, J, Brunt, E, Bugianesi, E, Byrne, C, Cabrera Cabrejos, M, Caldwell, S, Carr, R, Castellanos Fernandez, M, Castera, L, Castillo-Lopez, M, Caussy, C, Cerda-Reyes, E, Ceriello, A, Chan, W, Chang, Y, Charatcharoenwitthaya, P, Chavez-Tapia, N, Chung, R, Colombo, M, Coppell, K, Cotrim, H, Craxi, A, Crespo, J, Dassanayake, A, Davidson, N, De Knegt, R, de Ledinghen, V, Demir, M, Desalegn, H, Diago, M, Dillon, J, Dimmig, B, Dirac, M, Dirchwolf, M, Dufour, J, Dvorak, K, Ekstedt, M, El-Kassas, M, Elsanousi, O, Elsharkawy, A, Elwakil, R, Eskridge, W, Eslam, M, Esmat, G, Fan, J, Ferraz, M, Flisiak, R, Fortin, D, Fouad, Y, Freidman, S, Fuchs, M, Gadano, A, Gastaldelli, A, Geerts, A, Geier, A, George, J, Gerber, L, Ghazinyan, H, Gheorghe, L, Kile, D, Girala, M, Boon Bee, G, Goossens, N, Graupera, I, Gronbaek, H, Hamid, S, Hebditch, V, Henry, Z, Hickman, I, Hobbs, L, Hocking, S, Hofmann, W, Idilman, R, Iruzubieta, P, Isaacs, S, Isakov, V, Ismail, M, Jamal, M, Jarvis, H, Jepsen, P, Jornayvaz, F, Sudhamshu, K, Kakizaki, S, Karpen, S, Kawaguchi, T, Keating, S, Khader, Y, Kim, S, Kim, W, Kleiner, D, Koek, G, Joseph Komas, N, Kondili, L, Koot, B, Korenjak, M, Kotsiliti, E, Koulla, Y, Kugelmas, C, Kugelmas, M, Labidi, A, Lange, N, Lavine, J, Lazo, M, Leite, N, Lin, H, Lkhagvaa, U, Long, M, Lopez-Jaramillo, P, Lozano, A, Macedo, M, Malekzadeh, R, Marchesini, G, Marciano, S, Martinez, K, Martinez Vazquez, S, Mateva, L, Mato, J, Nlombi, C, Mccary, A, Mcintyre, J, Mckee, M, Mendive, J, Mikolasevic, I, Miller, P, Milovanovic, T, Milton, T, Moreno-Alcantar, R, Morgan, T, Motala, A, Muris, J, Musso, C, Nava-Gonzalez, E, Negro, F, Nersesov, A, Neuschwander-Tetri, B, Nikolova, D, Norris, S, Novak, K, Ocama, P, Ong, J, Ong-Go, A, Onyekwere, C, Padilla, M, Pais, R, Pan, C, Panduro, A, Panigrahi, M, Papatheodoridis, G, Paruk, I, Patel, K, Goncalves, C, Figueroa, M, Perez-Escobar, J, Pericas, J, Perseghin, G, Pessoa, M, Petta, S, Marques Souza de Oliveira, C, Prabhakaran, D, Pyrsopoulous, N, Rabiee, A, Ramji, A, Ratziu, V, Ravendhran, N, Ray, K, Roden, M, Romeo, S, Romero-Gomez, M, Rotman, Y, Rouabhia, S, Rowe, I, Sadirova, S, Alkhatry, M, Salupere, R, Satapathy, S, Schwimmer, J, Sebastiani, G, Seim, L, Seki, Y, Serme, A, Shapiro, D, Sharvadze, L, Shaw, J, Shawa, I, Shenoy, T, Shibolet, O, Shimakawa, Y, Shubrook, J, Singh, S, Sinkala, E, Skladany, L, Skrypnyk, I, Song, M, Sookoian, S, Sridharan, K, Stefan, N, Stine, J, Stratakis, N, Sheriff, D, Sundaram, S, Svegliati-Baroni, G, Swain, M, Tacke, F, Taheri, S, Tan, S, Tapper, E, Targher, G, Tcaciuc, E, Thiele, M, Tiniakos, D, Tolmane, I, Torre, A, Torres, E, Treeprasertsuk, S, Trenell, M, Turcan, S, Turcanu, A, Valantinas, J, van Kleef, L, Velarde Ruiz Velasco, J, Vesterhus, M, Vilar-Gomez, E, Waked, I, Wattacheril, J, Wedemeyer, H, Wilkins, F, Willemse, J, Wong, R, Yilmaz, Y, Yki-Jarvinen, H, Yu, M, Yumuk, V, Zeybel, M, Zheng, K, Zheng, M, Lazarus J. V., Mark H. E., Allen A. M., Arab J. P., Carrieri P., Noureddin M., Alazawi W., Alkhouri N., Alqahtani S. A., Arrese M., Bataller R., Berg T., Brennan P. N., Burra P., Castro-Narro G. E., Cortez-Pinto H., Cusi K., Dedes N., Duseja A., Francque S. M., Hagstrom H., Huang T. T. -K., Wajcman D. I., Kautz A., Kopka C. J., Krag A., Miller V., Newsome P. N., Rinella M. E., Romero D., Sarin S. K., Silva M., Spearman C. W., Tsochatzis E. A., Valenti L., Villota-Rivas M., Zelber-Sagi S., Schattenberg J. M., Wong V. W. -S., Younossi Z. M., Aberg F., Adams L., Al-Naamani K., Albadawy R. M., Alexa Z., Allison M., Alnaser F. A., Alswat K., Alvares-da-Silva M. R., Alvaro D., Alves-Bezerra M., Andrade R. J., Anstee Q. M., Awuku Y. A., Baatarkhuu O., Baffy G., Bakieva S., Bansal M. B., Barouki R., Batterham R. L., Behling C., Belfort-DeAguiar R., Berzigotti A., Betel M., Bianco C., Bosi E., Boursier J., Brunt E. M., Bugianesi E., Byrne C. J., Cabrera Cabrejos M. C., Caldwell S., Carr R., Castellanos Fernandez M. I., Castera L., Castillo-Lopez M. G., Caussy C., Cerda-Reyes E., Ceriello A., Chan W. -K., Chang Y., Charatcharoenwitthaya P., Chavez-Tapia N., Chung R. T., Colombo M., Coppell K., Cotrim H. P., Craxi A., Crespo J., Dassanayake A., Davidson N. O., De Knegt R., de Ledinghen V., Demir M., Desalegn H., Diago M., Dillon J. F., Dimmig B., Dirac M. A., Dirchwolf M., Dufour J. -F., Dvorak K., Ekstedt M., El-Kassas M., Elsanousi O. M., Elsharkawy A. M., Elwakil R., Eskridge W., Eslam M., Esmat G., Fan J. -G., Ferraz M. L., Flisiak R., Fortin D., Fouad Y., Freidman S. L., Fuchs M., Gadano A., Gastaldelli A., Geerts A., Geier A., George J., Gerber L. H., Ghazinyan H., Gheorghe L., Kile D. G., Girala M., Boon Bee G. G., Goossens N., Graupera I., Gronbaek H., Hamid S., Hebditch V., Henry Z., Hickman I. J., Hobbs L. A., Hocking S. L., Hofmann W. P., Idilman R., Iruzubieta P., Isaacs S., Isakov V. A., Ismail M. H., Jamal M. H., Jarvis H., Jepsen P., Jornayvaz F., Sudhamshu K. C., Kakizaki S., Karpen S., Kawaguchi T., Keating S. E., Khader Y., Kim S. U., Kim W., Kleiner D. E., Koek G., Joseph Komas N. P., Kondili L. A., Koot B. G., Korenjak M., Kotsiliti E., Koulla Y., Kugelmas C., Kugelmas M., Labidi A., Lange N. F., Lavine J. E., Lazo M., Leite N., Lin H. -C., Lkhagvaa U., Long M. T., Lopez-Jaramillo P., Lozano A., Macedo M. P., Malekzadeh R., Marchesini G., Marciano S., Martinez K., Martinez Vazquez S. E., Mateva L., Mato J. M., Nlombi C. M., McCary A. G., McIntyre J., McKee M., Mendive J. M., Mikolasevic I., Miller P. S., Milovanovic T., Milton T., Moreno-Alcantar R., Morgan T. R., Motala A., Muris J., Musso C., Nava-Gonzalez E. J., Negro F., Nersesov A. V., Neuschwander-Tetri B. A., Nikolova D., Norris S., Novak K., Ocama P., Ong J. P., Ong-Go A., Onyekwere C., Padilla M., Pais R., Pan C., Panduro A., Panigrahi M. K., Papatheodoridis G., Paruk I., Patel K., Goncalves C. P., Figueroa M. P., Perez-Escobar J., Pericas J. M., Perseghin G., Pessoa M. G., Petta S., Marques Souza de Oliveira C. P., Prabhakaran D., Pyrsopoulous N., Rabiee A., Ramji A., Ratziu V., Ravendhran N., Ray K., Roden M., Romeo S., Romero-Gomez M., Rotman Y., Rouabhia S., Rowe I. A., Sadirova S., Alkhatry M. S., Salupere R., Satapathy S. K., Schwimmer J. B., Sebastiani G., Seim L., Seki Y., Serme A. K., Shapiro D., Sharvadze L., Shaw J. E., Shawa I. T., Shenoy T., Shibolet O., Shimakawa Y., Shubrook J. H., Singh S. P., Sinkala E., Skladany L., Skrypnyk I., Song M. J., Sookoian S., Sridharan K., Stefan N., Stine J. G., Stratakis N., Sheriff D. S., Sundaram S. S., Svegliati-Baroni G., Swain M. G., Tacke F., Taheri S., Tan S. -S., Tapper E. B., Targher G., Tcaciuc E., Thiele M., Tiniakos D., Tolmane I., Torre A., Torres E. A., Treeprasertsuk S., Trenell M., Turcan S., Turcanu A., Valantinas J., van Kleef L. A., Velarde Ruiz Velasco J. A., Vesterhus M., Vilar-Gomez E., Waked I., Wattacheril J., Wedemeyer H., Wilkins F., Willemse J., Wong R. J., Yilmaz Y., Yki-Jarvinen H., Yu M. -L., Yumuk V., Zeybel M., Zheng K. I., and Zheng M. -H.

Abstract

Background & aims: An estimated 38% of adults worldwide have non-alcoholic fatty liver disease (NAFLD). From individual impacts to widespread public health and economic consequences, the implications of this disease are profound. This study aimed to develop an aligned, prioritised fatty liver disease research agenda for the global health community. Methods: Nine co-chairs drafted initial research priorities, subsequently reviewed by 40 core authors and debated during a three-day in-person meeting. Following a Delphi methodology, over two rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. The core group revised the draft priorities between rounds. In R2, panellists also ranked the priorities within six domains: epidemiology, models of care, treatment and care, education and awareness, patient and community perspectives, and leadership and public health policy. Results: The consensus-built fatty liver disease research agenda encompasses 28 priorities. The mean percentage of ‘agree’ responses increased from 78.3 in R1 to 81.1 in R2. Five priorities received unanimous combined agreement (‘agree’ + ‘somewhat agree’); the remaining 23 priorities had >90% combined agreement. While all but one of the priorities exhibited at least a super-majority of agreement (>66.7% ‘agree’), 13 priorities had [removed]90% combined agreement. Conclusions: Adopting this multidisciplinary consensus-built research priorities agenda can deliver a step-change in addressing fatty liver disease, mitigating against its individual and societal harms and proactively altering its natural history through prevention, identification, treatment, and care. This agenda should catalyse the global health community's efforts to advance and accelerate responses to this widespread and fast-growing public health threat. Impact and implications: An estimated 38% of adults and 13% o

Published
2023

8. Transmural Remission Improves Clinical Outcomes Up to 5 years in Crohn's Disease

Author

Raimundo Fernandes, S, Serrazina, J, Ayala Botto, I, Leal, T, Guimarães, A, Lemos Garcia, J, Rosa, I, Prata, R, Carvalho, D, Neves, J, Campelo, P, Ventura, S, Silva, A, Coelho, M, Sequeira, C, Oliveira, AP, Portela, F, Ministro, P, Tavares de Sousa, H, Ramos, J, Claro, I, Gonçalves, R, Araújo Correia, L, Tato Marinho, R, Cortez Pinto, H, and Magro, F

Subjects
Magnetic Resonance Imaging / methods, Crohn Disease* / diagnostic imaging, Remission Induction, Humans, HSAC GAS, Colonoscopy, Crohn Disease* / drug therapy, Retrospective Studies
Abstract

Introduction: Evidence supporting transmural remission (TR) as a long-term treatment target in Crohn's disease (CD) is still unavailable. Less stringent but more reachable targets such as isolated endoscopic (IER) or radiologic remission (IRR) may also be acceptable options in the long-term. Methods: Multicenter retrospective study including 404 CD patients evaluated by magnetic resonance enterography and colonoscopy. Five-year rates of hospitalization, surgery, use of steroids, and treatment escalation were compared between patients with TR, IER, IRR, and no remission (NR). Results: 20.8% of CD patients presented TR, 23.3% IER, 13.6% IRR and 42.3% NR. TR was associated with lower risk of hospitalization (odds-ratio [OR] 0.244 [0.111-0.538], p < 0.001), surgery (OR 0.132 [0.030-0.585], p = 0.008), steroid use (OR 0.283 [0.159-0.505], p < 0.001), and treatment escalation (OR 0.088 [0.044-0.176], p < 0.001) compared to no NR. IRR resulted in lower risk of hospitalization (OR 0.333 [0.143-0.777], p = 0.011) and treatment escalation (OR 0.260 [0.125-0.540], p < 0.001), while IER reduced the risk of steroid use (OR 0.442 [0.262-0.745], p = 0.002) and treatment escalation (OR 0.490 [0.259-0.925], p = 0.028) compared to NR. Conclusions: TR improved clinical outcomes over 5 years of follow-up in CD patients. Distinct but significant benefits were seen with IER and IRR. This suggests that both endoscopic and radiologic remission should be part of the treatment targets of CD. info:eu-repo/semantics/publishedVersion

Published
2023

9. Diagnostic accuracy of non-invasive tests for advanced fibrosis in patients with NAFLD : an individual patient data meta-analysis

Author

Mozes, F. E., Lee, J. A., Selvaraj, E. A., Jayaswal, A. N. A., Trauner, M., Boursier, J., Fournier, C., Staufer, K., Stauber, R. E., Bugianesi, E., Younes, R., Gaia, S., Lupsor-Platon, M., Petta, S., Shima, T., Okanoue, T., Mahadeva, S., Chan, W. -K., Eddowes, P. J., Newsome, P. N., Wong, V. W. -S., de Ledinghen, V., Fan, J., Shen, F., Cobbold, J. F., Sumida, Y., Okajima, A., Schattenberg, J. M., Labenz, C., Kim, W., Lee, M. S., Wiegand, J., Karlas, T., Yilmaz, Y., Aithal, G. P., Palaniyappan, N., Cassinotto, C., Aggarwal, S., Garg, H., Ooi, G. J., Nakajima, A., Yoneda, M., Ziol, M., Barget, N., Geier, A., Tuthill, T., Brosnan, M. J., Anstee, Q. M., Neubauer, S., Harrison, S. A., Bossuyt, P. M., Pavlides, M., Anstee, Q., Daly, A., Johnson, K., Govaere, O., Cockell, S., Tiniakos, D., Bedossa, P., Oakley, F., Cordell, H., Day, C., Wonders, K., Bossuyt, P., Zafarmand, H., Vali, Y., Lee, J., Ratziu, V., Clement, K., Pais, R., Schuppan, D., Schattenberg, J., Vidal-Puig, T., Vacca, M., Rodrigues-Cuenca, S., Allison, M., Kamzolas, I., Petsalaki, E., Oresic, M., Hyotylainen, T., Mcglinchey, A., Mato, J. M., Millet, O., Dufour, J. -F., Berzigotti, A., Harrison, S., Cobbold, J., Mozes, F., Akhtar, S., Banerjee, R., Kelly, M., Shumbayawonda, E., Dennis, A., Erpicum, C., Graham, M., Romero-Gomez, M., Gomez-Gonzalez, E., Ampuero, J., Castell, J., Gallego-Duran, R., Fernandez, I., Montero-Vallejo, R., Karsdal, M., Erhardtsen, E., Rasmussen, D., Leeming, D. J., Fisker, M. J., Sinisi, A., Musa, K., Betsou, F., Sandt, E., Tonini, M., Rosso, C., Armandi, A., Marra, F., Gastaldelli, A., Svegliati, G., Francque, S., Vonghia, L., Ekstedt, M., Kechagias, S., Yki-Jarvinen, H., Porthan, K., van Mil, S., Papatheodoridis, G., Cortez-Pinto, H., Valenti, L., Miele, L., Trautwein, C., Aithal, G., Hockings, P., Newsome, P., Wenn, D., Rodrigues, C. M. P., Chaumat, P., Hanf, R., Trylesinski, A., Ortiz, P., Duffin, K., Brosnan, J., Mcleod, E., Ertle, J., Ostroff, R., Alexander, L., Kjaer, M. S., Mikkelsen, L. F., Balp, M. -M., Brass, C., Jennings, L., Martic, M., Loeffler, J., Hanauer, G., Shankar, S., Pepin, K., Ehman, R., Myers, J., Ho, G., Torstenson, R., Myers, R., Doward, L., LITMUS Investigators, University of Denver, Medizinische Universität Wien = Medical University of Vienna, Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), SUACI Alpes du Nord, Medical University Graz, Mozes, Ferenc Emil, Lee, Jenny A., Selvaraj, Emmanuel Anandraj, Jayaswal, Arjun Narayan Ajmer, Trauner, Michael, Boursier, Jerome, Fournier, Celine, Staufer, Katharina, Stauber, Rudolf E., Bugianesi, Elisabetta, Younes, Ramy, Gaia, Silvia, Lupsor-Platon, Monica, Petta, Salvatore, Shima, Toshihide, Okanoue, Takeshi, Mahadeva, Sanjiv, Chan, Wah-Kheong, Eddowes, Peter J., Hirschfield, Gideon M., Newsome, Philip Noel, Wong, Vincent Wai-Sun, de Ledinghen, Victor, Fan, Jiangao, Shen, Feng, Cobbold, Jeremy F., Sumida, Yoshio, Okajima, Akira, Schattenberg, Joern M., Labenz, Christian, Kim, Won, Lee, Myoung Seok, Wiegand, Johannes, Karlas, Thomas, Yilmaz, Yusuf, Aithal, Guruprasad Padur, Palaniyappan, Naaventhan, Cassinotto, Christophe, Aggarwal, Sandeep, Garg, Harshit, Ooi, Geraldine J., Nakajima, Atsushi, Yoneda, Masato, Ziol, Marianne, Barget, Nathalie, Geier, Andreas, Tuthill, Theresa, Brosnan, M. Julia, Anstee, Quentin Mark, Neubauer, Stefan, Harrison, Stephen A., Bossuyt, Patrick M., Pavlides, Michael, Epidemiology and Data Science, APH - Methodology, APH - Personalized Medicine, ACS - Atherosclerosis & ischemic syndromes, APH - Aging & Later Life, ARD - Amsterdam Reproduction and Development, Graduate School, Mozes F.E., Lee J.A., Selvaraj E.A., Jayaswal A.N.A., Trauner M., Boursier J., Fournier C., Staufer K., Stauber R.E., Bugianesi E., Younes R., Gaia S., Lupsor-Platon M., Petta S., Shima T., Okanoue T., Mahadeva S., Chan W.-K., Eddowes P.J., Newsome P.N., Wong V.W.-S., de Ledinghen V., Fan J., Shen F., Cobbold J.F., Sumida Y., Okajima A., Schattenberg J.M., Labenz C., Kim W., Lee M.S., Wiegand J., Karlas T., Yilmaz Y., Aithal G.P., Palaniyappan N., Cassinotto C., Aggarwal S., Garg H., Ooi G.J., Nakajima A., Yoneda M., Ziol M., Barget N., Geier A., Tuthill T., Brosnan M.J., Anstee Q.M., Neubauer S., Harrison S.A., Bossuyt P.M., Pavlides M., Anstee Q., Daly A., Johnson K., Govaere O., Cockell S., Tiniakos D., Bedossa P., Oakley F., Cordell H., Day C., Wonders K., Bossuyt P., Zafarmand H., Vali Y., Lee J., Ratziu V., Clement K., Pais R., Schuppan D., Schattenberg J., Vidal-Puig T., Vacca M., Rodrigues-Cuenca S., Allison M., Kamzolas I., Petsalaki E., Oresic M., Hyotylainen T., McGlinchey A., Mato J.M., Millet O., Dufour J.-F., Berzigotti A., Harrison S., Cobbold J., Mozes F., Akhtar S., Banerjee R., Kelly M., Shumbayawonda E., Dennis A., Erpicum C., Graham M., Romero-Gomez M., Gomez-Gonzalez E., Ampuero J., Castell J., Gallego-Duran R., Fernandez I., Montero-Vallejo R., Karsdal M., Erhardtsen E., Rasmussen D., Leeming D.J., Fisker M.J., Sinisi A., Musa K., Betsou F., Sandt E., Tonini M., Rosso C., Armandi A., Marra F., Gastaldelli A., Svegliati G., Francque S., Vonghia L., Ekstedt M., Kechagias S., Yki-Jarvinen H., Porthan K., van Mil S., Papatheodoridis G., Cortez-Pinto H., Valenti L., Miele L., Trautwein C., Aithal G., Hockings P., Newsome P., Wenn D., Rodrigues C.M.P., Chaumat P., Hanf R., Trylesinski A., Ortiz P., Duffin K., Brosnan J., McLeod E., Ertle J., Ostroff R., Alexander L., Kjaer M.S., Mikkelsen L.F., Balp M.-M., Brass C., Jennings L., Martic M., Loeffler J., Hanauer G., Shankar S., Pepin K., Ehman R., Myers J., Ho G., Torstenson R., Myers R., and Doward L.

Subjects
Liver Cirrhosis, Male, Cirrhosis, LIVER STIFFNESS MEASUREMENT, Biopsy, [SDV]Life Sciences [q-bio], biostatistics, Gastroenterology, DISEASE, clinical decision making, fatty liver, hepatic fibrosis, 0302 clinical medicine, Non-alcoholic Fatty Liver Disease, Fibrosis, 2. Zero hunger, 0303 health sciences, medicine.diagnostic_test, NONALCOHOLIC STEATOHEPATITIS, TRANSIENT ELASTOGRAPHY, Fatty liver, CHRONIC HEPATITIS, Middle Aged, 3. Good health, Settore AGR/03 - Arboricoltura Generale E Coltivazioni Arboree, Liver, Liver biopsy, BIOPSY, Elasticity Imaging Techniques, Female, 030211 gastroenterology & hepatology, Median body, medicine.medical_specialty, CONTROLLED ATTENUATION PARAMETER, 610 Medicine & health, 03 medical and health sciences, Internal medicine, SCORE, medicine, Humans, biostatistics, clinical decision making, fatty liver, hepatic fibrosis, 030304 developmental biology, Receiver operating characteristic, business.industry, medicine.disease, Diabetes Mellitus, Type 2, XL PROBE, business, Hepatic fibrosis, Transient elastography, Biomarkers, PROSPECTIVE DERIVATION
Abstract

ObjectiveLiver biopsy is still needed for fibrosis staging in many patients with non-alcoholic fatty liver disease. The aims of this study were to evaluate the individual diagnostic performance of liver stiffness measurement by vibration controlled transient elastography (LSM-VCTE), Fibrosis-4 Index (FIB-4) and NAFLD (non-alcoholic fatty liver disease) Fibrosis Score (NFS) and to derive diagnostic strategies that could reduce the need for liver biopsies.DesignIndividual patient data meta-analysis of studies evaluating LSM-VCTE against liver histology was conducted. FIB-4 and NFS were computed where possible. Sensitivity, specificity and area under the receiver operating curve (AUROC) were calculated. Biomarkers were assessed individually and in sequential combinations.ResultsData were included from 37 primary studies (n=5735; 45% women; median age: 54 years; median body mass index: 30 kg/m2; 33% had type 2 diabetes; 30% had advanced fibrosis). AUROCs of individual LSM-VCTE, FIB-4 and NFS for advanced fibrosis were 0.85, 0.76 and 0.73. Sequential combination of FIB-4 cut-offs (ConclusionSequential combinations of markers with a lower cut-off to rule-out advanced fibrosis and a higher cut-off to rule-in cirrhosis can reduce the need for liver biopsies.

Published
2022
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10. A consensus integrated care pathway for patients with primary biliary cholangitis: a guideline-based approach to clinical care of patients

Author

Hirschfield, G, Chazouilleres, O, Cortez-Pinto, H, Macedo, G, de Ledinghen, V, Adekunle, F, Carbone, M, Hirschfield G. M., Chazouilleres O., Cortez-Pinto H., Macedo G., de Ledinghen V., Adekunle F., Carbone M., Hirschfield, G, Chazouilleres, O, Cortez-Pinto, H, Macedo, G, de Ledinghen, V, Adekunle, F, Carbone, M, Hirschfield G. M., Chazouilleres O., Cortez-Pinto H., Macedo G., de Ledinghen V., Adekunle F., and Carbone M.

Abstract

Introduction: Primary biliary cholangitis (PBC) is an infrequent, immune-mediated cholestatic liver disease, which can lead to liver fibrosis, cirrhosis and complications of end-stage liver disease. The established goals of treatment of PBC are prevention of end-stage liver disease and amelioration of associated symptoms. The European Association for the Study of the Liver (EASL) management guidelines provide extensive recommendations on the diagnosis and management of PBC. Areas covered: This article describes the development by expert consensus of a ‘PBC Integrated Patient Care Pathway’ to simplify and standardize the management of PBC for clinicians based on current practice. Expert opinion: Guideline adoption is potentially poor in practice since most patients with PBC in the community are seen by general gastroenterologists or hepatologists without a special interest in autoimmune liver disease. The PBC Integrated Patient Care Pathway is a best practice tool for clinicians designed to complement the EASL Clinical Practice Guidelines for the diagnosis and management of PBC patients. It gives clinicians a practical decision tree of the key steps in PBC management, thereby providing a simplified framework and an opportunity for more uniform practice that supports the safe and timely adoption of varied models of care provision to patients with PBC.

Published
2021

11. Hepatitis C: The beginning of the end—key elements for successful European and national strategies to eliminate HCV in Europe

Author

Papatheodoridis, G. V., Hatzakis, A., Cholongitas, E., Baptista‐Leite, R., Baskozos, I., Chhatwal, J., Colombo, M., Cortez‐Pinto, H., Craxi, A., Goldberg, D., Gore, C., Kautz, A., Lazarus, J. V., Mendão, L., Peck‐Radosavljevic, M., Razavi, H., Schatz, E., Tözün, N., van Damme, P., Wedemeyer, H., Yazdanpanah, Y., Zuure, F., and Manns, M. P.

Published
2018
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12. The EASL–Lancet Liver Commission: protecting the next generation of Europeans against liver disease complications and premature mortality

Author

Karlsen, TH, Sheron, N, Zelber-Sagi, S, Carrieri, P, Dusheiko, G, Bugianesi, E, Pryke, R, Hutchinson, SJ, Sangro, B, Martin, NK, Cecchini, M, Dirac, MA, Belloni, A, Serra-Burriel, M, Ponsioen, CY, Sheena, B, Lerouge, A, Devaux, M, Scott, N, Hellard, M, Verkade, HJ, Sturm, E, Marchesini, G, Yki-Järvinen, H, Byrne, CD, Targher, G, Tur-Sinai, A, Barrett, D, Ninburg, M, Reic, T, Taylor, A, Rhodes, T, Treloar, C, Petersen, C, Schramm, C, Flisiak, R, Simonova, MY, Pares, A, Johnson, P, Cucchetti, A, Graupera, I, Lionis, C, Pose, E, Fabrellas, N, Ma, AT, Mendive, JM, Mazzaferro, V, Rutter, H, Cortez-Pinto, H, Kelly, D, Burton, R, Lazarus, JV, Ginès, P, Buti, M, Newsome, PN, Burra, P, Manns, MP, Karlsen, TH, Sheron, N, Zelber-Sagi, S, Carrieri, P, Dusheiko, G, Bugianesi, E, Pryke, R, Hutchinson, SJ, Sangro, B, Martin, NK, Cecchini, M, Dirac, MA, Belloni, A, Serra-Burriel, M, Ponsioen, CY, Sheena, B, Lerouge, A, Devaux, M, Scott, N, Hellard, M, Verkade, HJ, Sturm, E, Marchesini, G, Yki-Järvinen, H, Byrne, CD, Targher, G, Tur-Sinai, A, Barrett, D, Ninburg, M, Reic, T, Taylor, A, Rhodes, T, Treloar, C, Petersen, C, Schramm, C, Flisiak, R, Simonova, MY, Pares, A, Johnson, P, Cucchetti, A, Graupera, I, Lionis, C, Pose, E, Fabrellas, N, Ma, AT, Mendive, JM, Mazzaferro, V, Rutter, H, Cortez-Pinto, H, Kelly, D, Burton, R, Lazarus, JV, Ginès, P, Buti, M, Newsome, PN, Burra, P, and Manns, MP

Published
2022

13. Advancing the global public health agenda for NAFLD: a consensus statement

Author

Lazarus, JV, Mark, HE, Anstee, QM, Arab, JP, Batterham, RL, Castera, L, Cortez-Pinto, H, Crespo, J, Cusi, K, Dirac, MA, Francque, S, George, J, Hagström, H, Huang, TT, Ismail, MH, Kautz, A, Sarin, SK, Loomba, R, Miller, V, Newsome, PN, Ninburg, M, Ocama, P, Ratziu, V, Rinella, M, Romero, D, Romero-Gómez, M, Schattenberg, JM, Tsochatzis, EA, Valenti, L, Wong, VW, Yilmaz, Y, Younossi, ZM, Zelber-Sagi, S, Consensus Consortium, NAFLD, and Byrne, Christopher

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver disease that affects approximately one-quarter of the global adult population, causing a substantial burden of ill health with wide-ranging social and economic implications. It is a multisystem disease and is considered the hepatic component of metabolic syndrome. Unlike other highly prevalent conditions, NAFLD has received little attention from the global public health community. Health system and public health responses to NAFLD have been weak and fragmented, and, despite its pervasiveness, NAFLD is largely unknown outside hepatology and gastroenterology. There is only a nascent global public health movement addressing NAFLD, and the disease is absent from nearly all national and international strategies and policies for non-communicable diseases, including obesity. In this global Delphi study, a multidisciplinary group of experts developed consensus statements and recommendations, which a larger group of collaborators reviewed over three rounds until consensus was achieved. The resulting consensus statements and recommendations address a broad range of topics — from epidemiology, awareness, care and treatment to public health policies and leadership — that have general relevance for policy-makers, health-care practitioners, civil society groups, research institutions and affected populations. These recommendations should provide a strong foundation for a comprehensive public health response to NAFLD.

Published
2022

14. Advancing the global public health agenda for NAFLD: a consensus statement

Author

Lazarus, J.V. Mark, H.E. Anstee, Q.M. Arab, J.P. Batterham, R.L. Castera, L. Cortez-Pinto, H. Crespo, J. Cusi, K. Dirac, M.A. Francque, S. George, J. Hagström, H. Huang, T.T.-K. Ismail, M.H. Kautz, A. Sarin, S.K. Loomba, R. Miller, V. Newsome, P.N. Ninburg, M. Ocama, P. Ratziu, V. Rinella, M. Romero, D. Romero-Gómez, M. Schattenberg, J.M. Tsochatzis, E.A. Valenti, L. Wong, V.W.-S. Yilmaz, Y. Younossi, Z.M. Zelber-Sagi, S. Åberg, F. Adams, L. Khatry, M.S.A. Naamani, K.A. Murillo, O.A. Allen, A.M. Alnaser, F. Alqahtani, S.A. Alswat, K. Alvaro, D. Andrade, R.J. Arrese, M. Awuku, Y.A. Ayesha, M. Baatarkhuu, O. Bakieva, S. Basu, R. Bataller, R. Bedri, S. Bosi, E. Bourliere, M. Bruha, R. Bugianesi, E. Burra, P. Buti, M. Byrne, C.D. Calleja, J.L. Carrieri, P. Carter, F. Fernandez, M.I.C. Castillo-Lopez, G. Castro-Narro, G.E. Chan, H.L.Y. Chan, W.-K. Chang, Y. Colombo, M. Coppell, K.J. Corey, K. Craxi, A. Cryer, D. Dassanayake, A. Martins, A.A.S. de Ledinghen, V. DelPrato, S. Demaio, A. Desalegn, H. Dillon, J. Duseja, A. Dorairaj, P. Ekstedt, M. El Kassas, M. Elsanousi, O.M. Esmat, G. Fan, J.-G. Farpour-Lambert, N. Flisiak, R. Fouad, Y. Fuchs, M. Gani, R.A. Gerber, L. Ghazinyan, H. Gheorghe, L. Goh, G.B.-B. Grønbæk, H. Gulnara, A. Hamid, S. Hebditch, V. Hickman, I.J. Hocking, S.L. Hunyady, B. Idilman, R. Isakov, V.A. Jamal, M.H. Jepsen, P. Iskandar, N.J. Song, M.J. Sudhamshu, K.C. Kakizaki, S. Kalamitsis, G. Kanwal, F. Kao, J.-H. Kaplan, L. Kawaguchi, T. Khader, Y. Kim, S.U. Kodjoh, N. Koek, G. Koike, K. Komas, N.P. Korenjak, M. Kugelmas, M. Labidi, A. Lange, N.F. Lavine, J.E. Lazo, M. Lee, N. Lesmana, C.R.A. Liu, C.-J. Long, M.T. Lopez-Jaramillo, P. Malekzadeh, R. Mahtab, M.A. Marchesini, G. Marinho, R. Vázquez, S.E.M. Mateva, L. Nlombi, C.M. Melin, P. Mikolasevic, I. Milovanovic, T. Musso, C. Nakajima, A. Nava, E. Nersesov, A.V. Nikolova, D. Norris, S. Novak, K. Oben, J. Ong, J.P. Onyekwere, C. Papatheodoridis, G. Paruk, I. Patel, K. Macedo, M.P. Penha-Gonçalves, C. Figueroa, M.P. Hofmann, W.P. Petta, S. de Oliveira, C.P.M.S. Puri, P. Pan, C.Q. Rac, M. Ralston, J. Ramji, A. Razavi, H. Alvares-da-Silva, M.R. Roberts, S. Roden, M. Rose, T. Rouabhia, S. Rovere-Querini, P. Rowe, I.A. Sadirova, S. Salupere, R. Saparbu, T. Sayegh, R. Sebastiani, G. Seki, Y. Selmo, J. Serme, A.K. Shaw, J.E. Shenoy, T. Sheron, N. Shibolet, O. Silva, M. Skrypnyk, I. Socha, P. Soriano, J. Spearman, C.W. Sridharan, K. Suárez, J.J. Sheriff, D.S. Sung, K.-C. Swain, M. Tacke, F. Taheri, S. Tan, S.-S. Tapper, E.B. Yki-Järvinen, H. Thiele, M. Shawa, I.T. Tolmane, I. Torres, E.A. Trauner, M. Treeprasertsuk, S. Turcanu, A. Valantinas, J. Vesterhus, M. Waked, I. Wild, S.H. Willemse, J. Wong, R.J. Xanthakos, S. Young, D.Y. Yu, M.-L. Zheng, K.I. Zeybel, M. Zheng, M.-H. the NAFLD Consensus Consortium

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver disease that affects approximately one-quarter of the global adult population, causing a substantial burden of ill health with wide-ranging social and economic implications. It is a multisystem disease and is considered the hepatic component of metabolic syndrome. Unlike other highly prevalent conditions, NAFLD has received little attention from the global public health community. Health system and public health responses to NAFLD have been weak and fragmented, and, despite its pervasiveness, NAFLD is largely unknown outside hepatology and gastroenterology. There is only a nascent global public health movement addressing NAFLD, and the disease is absent from nearly all national and international strategies and policies for non-communicable diseases, including obesity. In this global Delphi study, a multidisciplinary group of experts developed consensus statements and recommendations, which a larger group of collaborators reviewed over three rounds until consensus was achieved. The resulting consensus statements and recommendations address a broad range of topics — from epidemiology, awareness, care and treatment to public health policies and leadership — that have general relevance for policy-makers, health-care practitioners, civil society groups, research institutions and affected populations. These recommendations should provide a strong foundation for a comprehensive public health response to NAFLD. © 2021, Springer Nature Limited.

Published
2022

15. Body composition and body fat distribution are related to cardiac autonomic control in non-alcoholic fatty liver disease patients

Author

Pimenta, N.M., Santa-Clara, H., Cortez-Pinto, H., Silva-Nunes, J., Rosado, M. da Lapa, Sousa, P.J., Cale, R., Melo, X., Sardinha, L.B., and Fernhall, B.

Subjects
Body composition -- Physiological aspects, Heart beat -- Physiological aspects, Fatty liver -- Physiological aspects -- Analysis, Food/cooking/nutrition, Health
Abstract

BACKGROUND/OBJECTIVES: Heart rate recovery (HRR), a cardiac autonomic control marker, was shown to be related to body composition (BC), yet this was not tested in non-alcoholic fatty liver disease (NAFLD) patients. The aim of this study was to determine if, and to what extent, markers of BC and body fat (BF) distribution are related to cardiac autonomic control in NAFLD patients. SUBJECTS/METHODS: BC was assessed with dual-energy X-ray absorptiometry in 28 NAFLD patients (19 men, 51 ± 13 years, and 9 women, 47 ± 13 years). BF depots ratios were calculated to assess BF distribution. Subjects' HRR was recorded 1 (HRR1) and 2 min (HRR2) immediately after a maximum graded exercise test. RESULTS: BC and BF distribution were related to HRR;particularly weight, trunk BF and trunk BF-to-appendicular BF ratio showed a negative relation with HRR1 (r = - 0.613, r = - 0.597 and r =-0.547, respectively, P CONCLUSIONS: BC and BF distribution were related to HRR in NAFLD patients. Trunk BF-to-appendicular BF ratio was the best independent predictor of HRR and therefore may be best related to cardiovascular increased risk, and possibly act as a mediator in age-related cardiac autonomic control variation. European Journal of Clinical Nutrition (2014) 68, 241-246; doi: 10.1038/ejcn.2013.249; published online 4 December 2013 Keywords: regional body fat; dual-energy X-ray absorptiometry; hepatic steatosis; heart rate recovery; parasympathetic reactivation, INTRODUCTION Non -alcoholic fatty liver disease (NAFLD) is a condition present in up to 30% of the population in developed countries, with a considerably higher prevalence in the obese populations, [...]

Published
2014
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17. Alcohol‐Related Liver Disease: Areas of Consensus, Unmet Needs and Opportunities for Further Study†

Author

Szabo, Gyongyi, Kamath, Patrick S., Shah, Vijay H., Thursz, Mark, Mathurin, Philippe, EASL-AASLD Joint Meeting (Addolorato, G, Bataller, R, Burra, P, Castera, L, Cortez Pinto, H, Diehl, Am, Gao, B, Gilmore, Si, Hampe, J, Jürgen, R, Karin, M, Krag, A, Leon, D, Leptak, C, Louvet, A, Lucey, M, Mcclain, C, Nagy, L, Pageaux, Gp, Sanyal, A, Schnabl, B, Tiniakos, D, Trautwein, C, and Tsukamoto, H. ).

Subjects
0301 basic medicine, medicine.medical_specialty, Alcoholic liver disease, Hepatology, business.industry, MEDLINE, Context (language use), Disease, medicine.disease, 03 medical and health sciences, Liver disease, 030104 developmental biology, 0302 clinical medicine, Epidemiology, medicine, 030211 gastroenterology & hepatology, Translational science, Disease management (health), Intensive care medicine, business
Abstract

A joint meeting of the European Association for the Study of the Liver (EASL) and the American Association for the Study of Liver Diseases (AASLD) was held in London on September 30 and October 1, 2017. The goals of the meeting were to identify areas of broad agreement and disagreement, develop consensus, and determine future directions to ultimately reduce the burden, morbidity, and mortality of alcohol-related liver disease (previously termed alcoholic liver disease). The specific aims of the meeting were to identify unmet needs and areas for future investigation, in order to reduce alcohol consumption, develop markers for diagnosis and prognosis of disease, and create a framework to test novel pharmacological agents with pre-specified treatment endpoints. A table summary of these goals and aims is provided in the context of epidemiology, current management strategies, next steps for future trials and translational science.

Published
2019
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18. Diagnostic accuracy of non-invasive tests for advanced fibrosis in patients with NAFLD: An individual patient data meta-analysis

Author

Mózes, F.E. Lee, J.A. Selvaraj, E.A. Jayaswal, A.N.A. Trauner, M. Boursier, J. Fournier, C. Staufer, K. Stauber, R.E. Bugianesi, E. Younes, R. Gaia, S. Lupșor-Platon, M. Petta, S. Shima, T. Okanoue, T. Mahadeva, S. Chan, W.-K. Eddowes, P.J. Newsome, P.N. Wong, V.W.-S. de Ledinghen, V. Fan, J. Shen, F. Cobbold, J.F. Sumida, Y. Okajima, A. Schattenberg, J.M. Labenz, C. Kim, W. Lee, M.S. Wiegand, J. Karlas, T. Yılmaz, Y. Aithal, G.P. Palaniyappan, N. Cassinotto, C. Aggarwal, S. Garg, H. Ooi, G.J. Nakajima, A. Yoneda, M. Ziol, M. Barget, N. Geier, A. Tuthill, T. Brosnan, M.J. Anstee, Q.M. Neubauer, S. Harrison, S.A. Bossuyt, P.M. Pavlides, M. Anstee, Q. Daly, A. Johnson, K. Govaere, O. Cockell, S. Tiniakos, D. Bedossa, P. Oakley, F. Cordell, H. Day, C. Wonders, K. Bossuyt, P. Zafarmand, H. Vali, Y. Lee, J. Ratziu, V. Clement, K. Pais, R. Schuppan, D. Schattenberg, J. Schuppan, D. Schattenberg, J. Vidal-Puig, T. Vacca, M. Rodrigues-Cuenca, S. Allison, M. Kamzolas, I. Petsalaki, E. Oresic, M. Hyötyläinen, T. McGlinchey, A. Mato, J.M. Millet, O. Dufour, J.-F. Berzigotti, A. Pavlides, M. Harrison, S. Neubauer, S. Cobbold, J. Mozes, F. Akhtar, S. Banerjee, R. Kelly, M. Shumbayawonda, E. Dennis, A. Erpicum, C. Graham, M. Romero-Gómez, M. Gómez-González, E. Ampuero, J. Castell, J. Gallego-Durán, R. Fernández, I. Montero-Vallejo, R. Karsdal, M. Erhardtsen, E. Rasmussen, D. Leeming, D.J. Fisker, M.J. Sinisi, A. Musa, K. Betsou, F. Sandt, E. Tonini, M. Bugianesi, E. Rosso, C. Armandi, A. Marra, F. Gastaldelli, A. Svegliati, G. Boursier, J. Francque, S. Vonghia, L. Ekstedt, M. Kechagias, S. Yki-Jarvinen, H. Porthan, K. van Mil, S. Papatheodoridis, G. Cortez-Pinto, H. Valenti, L. Petta, S. Miele, L. Geier, A. Trautwein, C. Aithal, G. Hockings, P. Newsome, P. Wenn, D. Rodrigues, C.M.P. Chaumat, P. Hanf, R. Trylesinski, A. Ortiz, P. Duffin, K. Brosnan, J. Tuthill, T. McLeod, E. Ertle, J. Younes, R. Ostroff, R. Alexander, L. Kjær, M.S. Mikkelsen, L.F. Balp, M.-M. Brass, C. Jennings, L. Martic, M. Loeffler, J. Hanauer, G. Shankar, S. Fournier, C. Pepin, K. Ehman, R. Myers, J. Ho, G. Torstenson, R. Myers, R. Doward, L. LITMUS Investigators

Abstract

Objective Liver biopsy is still needed for fibrosis staging in many patients with non-alcoholic fatty liver disease. The aims of this study were to evaluate the individual diagnostic performance of liver stiffness measurement by vibration controlled transient elastography (LSM-VCTE), Fibrosis-4 Index (FIB-4) and NAFLD (non-alcoholic fatty liver disease) Fibrosis Score (NFS) and to derive diagnostic strategies that could reduce the need for liver biopsies. Design Individual patient data meta-analysis of studies evaluating LSM-VCTE against liver histology was conducted. FIB-4 and NFS were computed where possible. Sensitivity, specificity and area under the receiver operating curve (AUROC) were calculated. Biomarkers were assessed individually and in sequential combinations. Results Data were included from 37 primary studies (n=5735; 45% women; median age: 54 years; median body mass index: 30 kg/m2; 33% had type 2 diabetes; 30% had advanced fibrosis). AUROCs of individual LSM-VCTE, FIB-4 and NFS for advanced fibrosis were 0.85, 0.76 and 0.73. Sequential combination of FIB-4 cut-offs (

Published
2021

19. Diagnostic accuracy of elastography and magnetic resonance imaging in patients with NAFLD: A systematic review and meta-analysis

Author

Selvaraj, E.A. Mózes, F.E. Jayaswal, A.N.A. Zafarmand, M.H. Vali, Y. Lee, J.A. Levick, C.K. Young, L.A.J. Palaniyappan, N. Liu, C.-H. Aithal, G.P. Romero-Gómez, M. Brosnan, M.J. Tuthill, T.A. Anstee, Q.M. Neubauer, S. Harrison, S.A. Bossuyt, P.M. Pavlides, M. Daly, A. Johnson, K. Govaere, O. Cockell, S. Tiniakos, D. Bedossa, P. Oakley, F. Cordell, H. Day, C. Wonders, K. Bossuyt, P. Zafarmand, H. Lee, J. Ratziu, V. Clement, K. Pais, R. Schuppan, D. Schattenberg, J. Vidal-Puig, T. Vacca, M. Rodrigues-Cuenca, S. Allison, M. Kamzolas, I. Petsalaki, E. Oresic, M. Hyötyläinen, T. McGlinchey, A. Mato, J.M. Millet, O. Dufour, J.-F. Berzigotti, A. Harrison, S. Cobbold, J. Mozes, F. Akhtar, S. Banerjee, R. Kelly, M. Shumbayawonda, E. Dennis, A. Erpicum, C. Gómez-González, E. Ampuero, J. Castell, J. Gallego-Durán, R. Fernández, I. Montero-Vallejo, R. Karsdal, M. Erhardtsen, E. Rasmussen, D. Leeming, D.J. Fisker, M.J. Sinisi, A. Musa, K. Betsou, F. Sandt, E. Tonini, M. Bugianesi, E. Rosso, C. Armandi, A. Marra, F. Gastaldelli, A. Svegliati, G. Boursier, J. Francque, S. Vonghia, L. Ekstedt, M. Kechagias, S. Yki-Jarvinen, H. Luukkonen, P. van Mil, S. Papatheodoridis, G. Cortez-Pinto, H. Valenti, L. Petta, S. Miele, L. Geier, A. Trautwein, C. Aithal, G. Hockings, P. Newsome, P. Wenn, D. Pereira Rodrigues, C.M. Chaumat, P. Hanf, R. Trylesinski, A. Ortiz, P. Duffin, K. Brosnan, J. Tuthill, T. McLeod, E. Ertle, J. Younes, R. Ostroff, R. Alexander, L. Kjær, M.S. Mikkelsen, L.F. Balp, M.-M. Brass, C. Jennings, L. Martic, M. Loeffler, J. Hanauer, G. Shankar, S. Fournier, C. Pepin, K. Ehman, R. Myers, J. Ho, G. Torstenson, R. Myers, R. Doward, L. LITMUS Investigators

Abstract

Background and Aims: Vibration-controlled transient elastography (VCTE), point shear wave elastography (pSWE), 2-dimensional shear wave elastography (2DSWE), magnetic resonance elastography (MRE), and magnetic resonance imaging (MRI) have been proposed as non-invasive tests for patients with non-alcoholic fatty liver disease (NAFLD). This study evaluated their diagnostic accuracy for liver fibrosis and non-alcoholic steatohepatitis (NASH). Methods: PubMED/MEDLINE, EMBASE and the Cochrane Library were searched for studies examining the diagnostic accuracy of these index tests, against histology as the reference standard, in adult patients with NAFLD. Two authors independently screened and assessed methodological quality of studies and extracted data. Summary estimates of sensitivity, specificity and area under the curve (sAUC) were calculated for fibrosis stages and NASH, using a random effects bivariate logit-normal model. Results: We included 82 studies (14,609 patients). Meta-analysis for diagnosing fibrosis stages was possible in 53 VCTE, 11 MRE, 12 pSWE and 4 2DSWE studies, and for diagnosing NASH in 4 MRE studies. sAUC for diagnosis of significant fibrosis were: 0.83 for VCTE, 0.91 for MRE, 0.86 for pSWE and 0.75 for 2DSWE. sAUC for diagnosis of advanced fibrosis were: 0.85 for VCTE, 0.92 for MRE, 0.89 for pSWE and 0.72 for 2DSWE. sAUC for diagnosis of cirrhosis were: 0.89 for VCTE, 0.90 for MRE, 0.90 for pSWE and 0.88 for 2DSWE. MRE had sAUC of 0.83 for diagnosis of NASH. Three (4%) studies reported intention-to-diagnose analyses and 15 (18%) studies reported diagnostic accuracy against pre-specified cut-offs. Conclusions: When elastography index tests are acquired successfully, they have acceptable diagnostic accuracy for advanced fibrosis and cirrhosis. The potential clinical impact of these index tests cannot be assessed fully as intention-to-diagnose analyses and validation of pre-specified thresholds are lacking. Lay summary: Non-invasive tests that measure liver stiffness or use magnetic resonance imaging (MRI) have been suggested as alternatives to liver biopsy for assessing the severity of liver scarring (fibrosis) and fatty inflammation (steatohepatitis) in patients with non-alcoholic fatty liver disease (NAFLD). In this study, we summarise the results of previously published studies on how accurately these non-invasive tests can diagnose liver fibrosis and inflammation, using liver biopsy as the reference. We found that some techniques that measure liver stiffness had a good performance for the diagnosis of severe liver scarring. © 2021 The Author(s)

Published
2021

21. Recent advances in alcohol-related liver disease (ALD): summary of a Gut roundtable meeting

Author

Avila, M.A. (Matías Antonio), Dufour, J.F. (Jean-Francois), Gerbes, A. (Alexander), Zoulim, F. (Fabien), Bataller, R. (Ramón), Burra, P. (Patrizia), Cortez-Pinto, H. (Helena), Gao, B. (Bin), Gilmore, I. (Ian), Mathurin, P. (Philippe), Moreno, C. (Christophe), Poznyak, V. (Vladimir), Schnabl, B. (Bernd), Szabo, G. (Gyongyi), Thiele, M. (Maja), and Thursz, M.R. (Mark R.)

Subjects
Alcohol use disorder, Alcohol-related liver disease, Steatosis, Cirrhosis, The gut-liver axis, Acute on chronic liver failure, Alcohol consumption, Alcoholic hepatitis, Fibrosis, Liver transplant, Animal modelsTherapeutic targets
Abstract

Alcohol-related liver disease (ALD), which includes a range of disorders of different severity and is one of the most prevalent types of liver disease worldwide, has recently regained increased attention. Among other reasons, the realisation that any alcohol intake, regardless of type of beverage represents a health risk, and the new therapeutic strategies tested in recently published or undergoing clinical trials spur scientific interest in this area. In April 2019, Gut convened a round table panel of experts during the European Association for the Study of the Liver (EASL) International Liver Congress (ILC) in Vienna to discuss critical and up-to-date issues and clinical trial data regarding ALD, its epidemiology, diagnosis, management, pathomechanisms, possible future treatments and prevention. This paper summarises the discussion and its conclusions.

Published
2020

22. The European NAFLD Registry: A real-world longitudinal cohort study of nonalcoholic fatty liver disease

Author

Hardy, T. Wonders, K. Younes, R. Aithal, G.P. Aller, R. Allison, M. Bedossa, P. Betsou, F. Boursier, J. Brosnan, M.J. Burt, A. Cobbold, J. Cortez-Pinto, H. Day, C.P. Dufour, J.-F. Ekstedt, M. Francque, S. Harrison, S. Miele, L. Nasr, P. Papatheodoridis, G. Petta, S. Tiniakos, D. Torstenson, R. Valenti, L. Holleboom, A.G. Yki-Jarvinen, H. Geier, A. Romero-Gomez, M. Ratziu, V. Bugianesi, E. Schattenberg, J.M. Anstee, Q.M. on behalf of the LITMUS Consortium

Abstract

Non-Alcoholic Fatty Liver Disease (NAFLD), a progressive liver disease that is closely associated with obesity, type 2 diabetes, hypertension and dyslipidaemia, represents an increasing global public health challenge. There is significant variability in the disease course: the majority exhibit only fat accumulation in the liver but a significant minority develop a necroinflammatory form of the disease (non-alcoholic steatohepatitis, NASH) that may progress to cirrhosis and hepatocellular carcinoma. At present our understanding of pathogenesis, disease natural history and long-term outcomes remain incomplete. There is a need for large, well characterised patient cohorts that may be used to address these knowledge gaps and to support the development of better biomarkers and novel therapies. The European NAFLD Registry is an international, prospectively recruited observational cohort study that aims to establish a large, highly-phenotyped patient cohort and linked bioresource. Here we describe the infrastructure, data management and monitoring plans, and the standard operating procedures implemented to ensure the timely and systematic collection of high-quality data and samples. Already recruiting subjects at secondary/tertiary care centres across Europe, the Registry is supporting the European Union IMI2-funded LITMUS ‘Liver Investigation: Testing Marker Utility in Steatohepatitis’ consortium, which is a major international effort to robustly validate biomarkers that diagnose, risk stratify and/or monitor NAFLD progression and liver fibrosis stage. The European NAFLD Registry has the demonstrable capacity to support research and biomarker development at scale and pace. © 2020 The Author(s)

Published
2020

23. A cross-sectional study of the public health response to non-alcoholic fatty liver disease in Europe

Author

Lazarus, J.V., Ekstedt, Mattias, Marchesini, G., Mullen, J., Novak, K., Pericàs, J.M., Roel, E., Romero-Gómez, M., Ratziu, V., Tacke, F., Cortez-Pinto, H., Anstee, Q.M., EASL, International Liver Foundation NAFLD Policy Review Collaborators, Lazarus, J.V., Ekstedt, Mattias, Marchesini, G., Mullen, J., Novak, K., Pericàs, J.M., Roel, E., Romero-Gómez, M., Ratziu, V., Tacke, F., Cortez-Pinto, H., Anstee, Q.M., and EASL, International Liver Foundation NAFLD Policy Review Collaborators

Abstract

Background & Aims Non-alcoholic fatty liver disease (NAFLD) is a growing public health problem worldwide and has become an important field of biomedical inquiry. We aimed to determine whether European countries have mounted an adequate public health response to NAFLD and non-alcoholic steatohepatitis (NASH). Methods In 2018 and 2019, NAFLD experts in 29 European countries completed an English-language survey on policies, guidelines, awareness, monitoring, diagnosis and clinical assessment in their country. The data were compiled, quality checked against existing official documents and reported descriptively. Results None of the 29 participating countries had written strategies or action plans for NAFLD. Two countries (7%) had mentions of NAFLD or NASH in related existing strategies (obesity and alcohol). Ten (34%) reported having national clinical guidelines specifically addressing NAFLD and, upon diagnosis, all included recommendations for the assessment of diabetes and liver cirrhosis. Eleven countries (38%) recommended screening for NAFLD in all patients with either diabetes, obesity and/or metabolic syndrome. Five countries (17%) had referral algorithms for follow-up and specialist referral in primary care, and 7 (24%) reported structured lifestyle programmes aimed at NAFLD. Seven (24%) had funded awareness campaigns that specifically included prevention of liver disease. Four countries (14%) reported having civil society groups which address NAFLD and 3 countries (10%) had national registries that include NAFLD. Conclusions We found that a comprehensive public health response to NAFLD is lacking in the surveyed European countries. This includes policy in the form of a strategy, clinical guidelines, awareness campaigns, civil society involvement, and health systems organisation, including registries. Lay summary We conducted a survey on non-alcoholic fatty liver disease with experts in European countries, coupled with data extracted from official documents o, Funding agencies: EASL International Liver Foundation from Gilead Sciences Europe Ltd.; Allergan Pharmaceutical International Ltd.Allergan; Bristol-Myers-Squibb CompanyBristol-Myers Squibb; Pfizer Inc.Pfizer; Resoundant Inc.; Miguel Servet; Horizon 2020 Framework Program o

Published
2020
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24. The European NAFLD Registry: A real-world longitudinal cohort study of nonalcoholic fatty liver disease

Author

Hardy, T., Wonders, K., Younes, R., Aithal, G. P., Aller, R., Allison, M., Bedossa, P., Betsou, F., Boursier, J., Brosnan, M. J., Burt, A., Cobbold, J., Cortez-Pinto, H., Day, C. P., Dufour, J. -F., Ekstedt, M., Francque, S., Harrison, S., Miele, Luca, Nasr, P., Papatheodoridis, G., Petta, S., Tiniakos, D., Torstenson, R., Valenti, L., Holleboom, A. G., Yki-Jarvinen, H., Geier, A., Romero-Gomez, M., Ratziu, V., Bugianesi, E., Schattenberg, J. M., Anstee, Q. M., Miele L. (ORCID:0000-0003-3464-0068), Hardy, T., Wonders, K., Younes, R., Aithal, G. P., Aller, R., Allison, M., Bedossa, P., Betsou, F., Boursier, J., Brosnan, M. J., Burt, A., Cobbold, J., Cortez-Pinto, H., Day, C. P., Dufour, J. -F., Ekstedt, M., Francque, S., Harrison, S., Miele, Luca, Nasr, P., Papatheodoridis, G., Petta, S., Tiniakos, D., Torstenson, R., Valenti, L., Holleboom, A. G., Yki-Jarvinen, H., Geier, A., Romero-Gomez, M., Ratziu, V., Bugianesi, E., Schattenberg, J. M., Anstee, Q. M., and Miele L. (ORCID:0000-0003-3464-0068)

Abstract

Non-Alcoholic Fatty Liver Disease (NAFLD), a progressive liver disease that is closely associated with obesity, type 2 diabetes, hypertension and dyslipidaemia, represents an increasing global public health challenge. There is significant variability in the disease course: the majority exhibit only fat accumulation in the liver but a significant minority develop a necroinflammatory form of the disease (non-alcoholic steatohepatitis, NASH) that may progress to cirrhosis and hepatocellular carcinoma. At present our understanding of pathogenesis, disease natural history and long-term outcomes remain incomplete. There is a need for large, well characterised patient cohorts that may be used to address these knowledge gaps and to support the development of better biomarkers and novel therapies. The European NAFLD Registry is an international, prospectively recruited observational cohort study that aims to establish a large, highly-phenotyped patient cohort and linked bioresource. Here we describe the infrastructure, data management and monitoring plans, and the standard operating procedures implemented to ensure the timely and systematic collection of high-quality data and samples. Already recruiting subjects at secondary/tertiary care centres across Europe, the Registry is supporting the European Union IMI2-funded LITMUS ‘Liver Investigation: Testing Marker Utility in Steatohepatitis’ consortium, which is a major international effort to robustly validate biomarkers that diagnose, risk stratify and/or monitor NAFLD progression and liver fibrosis stage. The European NAFLD Registry has the demonstrable capacity to support research and biomarker development at scale and pace.

Published
2020

32. Range of Normal Liver Stiffness and Factors Associated With Increased Stiffness Measurements in Apparently Healthy Individuals

Author

Bazerbachi, F. Haffar, S. Wang, Z. Cabezas, J. Arias-Loste, M.T. Crespo, J. Darwish-Murad, S. Ikram, M.A. Olynyk, J.K. Gan, E. Petta, S. Berzuini, A. Prati, D. de Lédinghen, V. Wong, V.W. Del Poggio, P. Chávez-Tapia, N.C. Chen, Y.-P. Cheng, P.-N. Yuen, M.-F. Das, K. Chowdhury, A. Caballeria, L. Fabrellas, N. Ginès, P. Kumar, M. Sarin, S.K. Conti, F. Andreone, P. Sirli, R. Cortez-Pinto, H. Carvalhana, S. Sugihara, T. Kim, S.U. Parikh, P. Chayama, K. Corpechot, C. Kim, K.M. Papatheodoridis, G. Alsebaey, A. Kamath, P.S. Murad, M.H. Watt, K.D.

Abstract

Background & Aims: Transient elastography (TE) is a noninvasive technique used to measure liver stiffness to estimate the severity of fibrosis. The range of liver stiffness measurements (LSMs) in healthy individuals is unclear. We performed a systematic review to determine the range of LSMs, examined by TE, in healthy individuals and individuals who are susceptible to fibrosis. Methods: We collected data from 16,082 individuals, in 26 cohorts, identified from systematic searches of Embase, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews for studies of liver stiffness measurements. Studies analyzed included apparently healthy adults (normal levels of liver enzymes, low-risk alcohol use patterns, and negative for markers of viral hepatitis). The presence of diabetes, hypertension, dyslipidemia, or steatosis, based on ultrasound examination, was known for most participants. We performed a meta-analysis of data from individual participants. The cohort was divided into 4 groups; participants with a body mass index

Published
2019

35. Range of Normal Liver Stiffness and Factors Associated With Increased Stiffness Measurements in Apparently Healthy Individuals

Author

Bazerbachi, F., Haffar, S., Wang, Z., Cabezas, J., Arias-Loste, M., Crespo, J., Darwish-Murad, S., Ikram, M., Olynyk, John, Gan, E., Petta, S., Berzuini, A., Prati, D., de Lédinghen, V., Wong, V., Del Poggio, P., Chávez-Tapia, N., Chen, Y., Cheng, P., Yuen, M., Das, K., Chowdhury, A., Caballeria, L., Fabrellas, N., Ginès, P., Kumar, M., Sarin, S., Conti, F., Andreone, P., Sirli, R., Cortez-Pinto, H., Carvalhana, S., Sugihara, T., Kim, S., Parikh, P., Chayama, K., Corpechot, C., Kim, K., Papatheodoridis, G., Alsebaey, A., Kamath, P., Murad, M., Watt, K., Bazerbachi, F., Haffar, S., Wang, Z., Cabezas, J., Arias-Loste, M., Crespo, J., Darwish-Murad, S., Ikram, M., Olynyk, John, Gan, E., Petta, S., Berzuini, A., Prati, D., de Lédinghen, V., Wong, V., Del Poggio, P., Chávez-Tapia, N., Chen, Y., Cheng, P., Yuen, M., Das, K., Chowdhury, A., Caballeria, L., Fabrellas, N., Ginès, P., Kumar, M., Sarin, S., Conti, F., Andreone, P., Sirli, R., Cortez-Pinto, H., Carvalhana, S., Sugihara, T., Kim, S., Parikh, P., Chayama, K., Corpechot, C., Kim, K., Papatheodoridis, G., Alsebaey, A., Kamath, P., Murad, M., and Watt, K.

Abstract

Background & Aims: Transient elastography (TE) is a noninvasive technique used to measure liver stiffness to estimate the severity of fibrosis. The range of liver stiffness measurements (LSMs) in healthy individuals is unclear. We performed a systematic review to determine the range of LSMs, examined by TE, in healthy individuals and individuals who are susceptible to fibrosis. Methods: We collected data from 16,082 individuals, in 26 cohorts, identified from systematic searches of Embase, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews for studies of liver stiffness measurements. Studies analyzed included apparently healthy adults (normal levels of liver enzymes, low-risk alcohol use patterns, and negative for markers of viral hepatitis). The presence of diabetes, hypertension, dyslipidemia, or steatosis, based on ultrasound examination, was known for most participants. We performed a meta-analysis of data from individual participants. The cohort was divided into 4 groups; participants with a body mass index <30 kg/m2 were examined with the medium probe and those with a body mass index =30 kg/m2 were examined with the extra-large probe. Linear regression models were conducted after adjusting for potential confounding factors of LSMs. We performed several sensitivity analyses. Results: We established LSM ranges for healthy individuals measured with both probes—these did not change significantly in sensitivity analyses of individuals with platelets =150,000/mm3 and levels of alanine aminotransferase =33 IU/L in men or =25 IU/L in women. In multivariate analysis, factors that modified LSMs with statistical significance included diabetes, dyslipidemia, waist circumference, level of aspartate aminotransferase, and systolic blood pressure at examination time. Significant increases in LSMs were associated with the metabolic syndrome in individuals examined by either probe. Diabetes in obese individuals increased

Published
2019

36. Hepatitis C: The beginning of the end—key elements for successful European and national strategies to eliminate HCV in Europe

Author

Papatheodoridis, G.V. Hatzakis, A. Cholongitas, E. Baptista-Leite, R. Baskozos, I. Chhatwal, J. Colombo, M. Cortez-Pinto, H. Craxi, A. Goldberg, D. Gore, C. Kautz, A. Lazarus, J.V. Mendão, L. Peck-Radosavljevic, M. Razavi, H. Schatz, E. Tözün, N. van Damme, P. Wedemeyer, H. Yazdanpanah, Y. Zuure, F. Manns, M.P.

Abstract

Hepatitis C virus (HCV) infection is a major public health problem in the European Union (EU). An estimated 5.6 million Europeans are chronically infected with a wide range of variation in prevalence across European Union countries. Although HCV continues to spread as a largely “silent pandemic,” its elimination is made possible through the availability of the new antiviral drugs and the implementation of prevention practices. On 17 February 2016, the Hepatitis B & C Public Policy Association held the first EU HCV Policy Summit in Brussels. This summit was an historic event as it was the first high-level conference focusing on the elimination of HCV at the European Union level. The meeting brought together the main stakeholders in the field of HCV: clinicians, patient advocacy groups, representatives of key institutions and regional bodies from across European Union; it served as a platform for one of the most significant disease elimination campaigns in Europe and culminated in the presentation of the HCV Elimination Manifesto, calling for the elimination of HCV in Europe by 2030. The launch of the Elimination Manifesto provides a starting point for action in order to make HCV and its elimination in Europe an explicit public health priority, to ensure that patients, civil society groups and other relevant stakeholders will be directly involved in developing and implementing HCV elimination strategies, to pay particular attention to the links between hepatitis C and social marginalization and to introduce a European Hepatitis Awareness Week. © 2018 John Wiley & Sons Ltd

Published
2018

43. Characteristics associated with non-response to ursodeoxycholic acid in primary biliary cholangitis

Author

Dias, T., primary, Santos, A., additional, Carvalho, J., additional, Bento-Miranda, M., additional, Sant’anna, M., additional, Calinas, F., additional, Loureiro, R., additional, Martins, A., additional, Alexandrino, G., additional, Cotrim, I., additional, Martins, C., additional, Presa, J., additional, Mesquita, M., additional, Nunes, J., additional, Ferreira, A., additional, Horta e Vale, A., additional, Alves, A.L.C., additional, Pedroto, I., additional, Maia, L., additional, Banhudo, A., additional, Mocanu, I., additional, Laranjo, A.M., additional, Lopes, S., additional, Liberal, R., additional, Fonseca, C., additional, Oliveira, J., additional, Gomes, M., additional, and Cortez-Pinto, H., additional

Published
2018
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44. Role of alpha-1 antitrypsin genotypes in the progression of adult liver disease

Author

Pereira, V., primary, Gaspar, R., additional, Simões, C., additional, Maia, L., additional, Costa, D., additional, Carvão, J., additional, Oliveira, A., additional, Serrão, G., additional, Jesus, V., additional, Sucena, M.C., additional, Santos, C., additional, Gomes, J., additional, Lages, J., additional, Abreu, I., additional, Freitas, S., additional, Carvalhana, S., additional, Mandorfer, M., additional, Cortez-Pinto, H., additional, Macedo, G., additional, Trauner, M., additional, Liberal, R., additional, and Jasmins, L., additional

Published
2018
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45. Hepatic steatosis in an adult population: stronger correlation with the presence of obesity and insulin resistence than with the dietary pattern. Results from a cross-sectional study

Author

Leitao, J.A.M.C.P., primary, Cochicho, J., additional, Carvalhana, S., additional, Velasco, F., additional, Silva, A.P., additional, Medeiros, I.S., additional, Alves, A.C., additional, Bourbon, M., additional, Oliveiros, B., additional, Rodrigues, V., additional, Carvalho, A., additional, and Cortez-Pinto, H., additional

Published
2018
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48. Hepatic steatosis in an adult population: stronger correlation with the presence of obesity and insulin resistance than with the dietary pattern. Results from a cross-sectional study

Author

Leitão, J., primary, Cochicho, J., additional, Carvalhana, S., additional, Velasco, F., additional, Silva, A., additional, Medeiros, I., additional, Alves, A.C., additional, Bourbon, M., additional, Oliveiros, B., additional, Rodrigues, V., additional, Carvalho, A., additional, and Cortez-Pinto, H., additional

Published
2017
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49. miR-21 ablation and obeticholic acid ameliorate NASH in mice

Author

Rodrigues, P.M., primary, Afonso, M.B., additional, Simão, A.L., additional, Carvalho, C.C., additional, Trindade, A., additional, Duarte, A., additional, Borralho, P.M., additional, Machado, M.V., additional, Cortez-Pinto, H., additional, Rodrigues, C.M.P., additional, and Castro, R.E., additional

Published
2017
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50. Normal values of liver stiffness as measured by transient elastography: pooled individual participant data meta-analysis from 26 studies and 14,883 participants

Author

Bazerbachi, F., primary, Haffar, S., additional, Wang, Z., additional, González, J.C., additional, Arias-Loste, M.T., additional, Crespo, J., additional, Darwish-Murad, S., additional, Ikram, M.A., additional, Petta, S., additional, Berzuini, A., additional, Prati, D., additional, de Lédinghen, V., additional, Wong, V., additional, Del Poggio, P., additional, Chávez-Tapia, N.C., additional, Chen, Y.-P., additional, Cheng, P.-N., additional, Yuen, M.-F., additional, Das, K., additional, Chowdhury, A., additional, Caballería, L., additional, Fabrellas, N., additional, Ginès, P., additional, Kumar, M., additional, Sarin, S.K., additional, Conti, F., additional, Andreone, P., additional, Sirli, R., additional, Cortez-Pinto, H., additional, Carvalhana, S., additional, Sugihara, T., additional, Kim, S.-U., additional, Parikh, P., additional, Chayama, K., additional, Corpechot, C., additional, Kim, K.-M., additional, Papatheodoridis, G., additional, Alsebaey, A., additional, Olynyk, J.K., additional, Gan, E., additional, Kamath, P., additional, Watt, K.D., additional, and Murad, M.H., additional

Published
2017
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