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In a follow-up preview, Jörn Schattenberg, Louise Campbell, Mazen Noureddin, Ian Rowe and patient advocate Jeff McIntyre join Roger Green to discuss key presentations and posters of interest at the 73rd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD). On November 4th-8th in Washington DC, as many as 10,000 attendees will convene in an effort to advance and disseminate the science and practice of hepatology, and to promote liver health and quality patient care.

Louise leads this conversation with commentary carrying over from last week’s discussion on FibroScan as an essential test. Her hope remains that FibroScan be utilized in the early screening process, noting that many patients with poor liver health are still captured much too late in the process. She agrees with the consensus that, while imperfect, FIB-4 currently has the potential to improve patient capture rates. Mazen follows up with a comment on the nature of PPV being highly subjective to both test accuracy and patient population.

Ian suggests that some of the preceding conversation anchors performance of these tests to biopsy. Interested in moving beyond biopsy, he points out presentations which compare outcomes of patients according to either biopsy or associated noninvasive tests. The first paper he notes is titled Prognostic Value of Non-Invasive Tests in Patients with NAFLD. This study looks at outcomes for 1,700 patients with various non-invasive tests and demonstrates the value of each in predicting outcomes. Ian explains the conclusion is that NITs should be accepted as surrogate tests for clinical trials. He then looks at a presentation by Samer Gawrieh which correlates VCTE values with progression to cirrhosis and clinical events. He believes this to be the direction in which the field should move.

Mazen agrees with the idea that as data accumulates around NITs, we can better understand how longitudinal changes impact outcomes. He then briefly describes other presentations and posters at this meeting that address similar topics. His final comments describe the FDA’s interest in NITs: how do we give meaning to improvements in the efficacy of NITS and how do these improvements translate into better outcomes.