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SurfingNASH is covering each day of NASH-TAG 2022. This episode is a "morning after" conversation with Stephen Harrison, Louise Campbell and Jörn Schattenberg reviewing key points of the Day Two discussions, with particular focus on the two "fireside chats" that wrapped up the program.

Day Two of NASH-TAG included presentations of new data on wet markers, imaging and combination therapy, discussion of novel targets and advances in our understanding of basic science. All this led up to the meeting's climax + denouement: David Shapiro's talk on why the current trial and approval system is unsustainable and places unnecessary burden on patients, developers and investors, followed by two "fireside" chats that were, in fact, calls to action to rethink the appropriateness of clinical trial endpoints driven by so-called "semi-quantitative" histopathology reads driven by liver biopsy.

The day produced bold arguments, exceptional images, and some compelling new facts and perspectives. It was also long: Roger, Stephen and Louise started with a 6:15a MST SurfingNASH recording session and went through until the 8:15p MST program adjournment (for Louise in the UK, the cirrhosis fireside chat ended after 3:00a Sunday morning!) The next morning, the group met to review the speeches, slides and impassioned moments of a compelling, powerful day.

In the process, they revisited some of the day's high points, culminating in powerful statements on the problems with current clinical trial endpoints articulated by Stephen Harrison for non-cirrhotic trials and Vlad Ratziu for cirrhotic trials and supported by a powerful statement by Global Liver Institute Founder and CEO Donna Cryer focusing on how the current trial endpoint system places patients under undue burden and unnecessary, sometimes mortal, risk.