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Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy past month at both the 2023 EASL Congress and the American Diabetes Association's 83rd Scientific Sessions. For this feature, Sven Francque (University of Antwerp) and Ian Rowe (University of Leeds) join Jörn Schattenberg and Roger Green to discuss a range of fascinating topics to emerge at the EASL Congress meeting held in Vienna.

The episode begins on the subject of new NAFLD/NASH nomenclature. Sven provides a cogent summary of the background, processes and decisions related to the name changes. The other panelists respond with varying perspectives and expand on the  following ideas that emerge:

• the changes reflect an opportunity to study metabolically at-risk populations that consume more than little-to-no alcohol
• the adoption of more neutral scientific terms  - steatotic rather than fatty -destigmatizes the condition
• In general, improved clarity around definition of disease is a positive step forward in putting a major dent in the pandemic 

The conversation shifts to practical considerations around how to implement the changes in different settings and with patients. Read more about the switch to steatotic liver disease (SLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) here.

The group refocuses on posters and presentations that they find critical and/or compelling. Ian points to a presentation from Vincent Wong titled A clinical care pathway to detect advanced liver disease in patients with type 2 diabetes through automated fibrosis score calculation and electronic reminder messages: a randomised controlled trial. Ian suggests that this study proves both the value of working to identify more patients and the considerable amount of work remaining in this area. Roger next mentions a population study from South Korea looking to identify patients with steatotic liver disease, but not cirrhosis, that will progress to HCC over a ten year period. After the group comments on this study, Jörn highlights a paper which unpacks how little is known about the mechanisms of fibrosis resolution beyond the idea that there are clear differences between the progression and regression processes. Sven then chooses to discuss another paper by Vincent Wong that correlated liver stiffness with risk of decompensation and HCC. This leads to comments around the plausibility of shifting from biopsy to NITs and insights around the cost effectiveness and the frequency of testing. On the flip side, Ian underscores a study that investigates identification of a gene signature that will accurately predict the risk of decompensation and, ultimately, determine how to make better use of the biopsy tissue received in research. Finally, the session winds down with a closing question around what to expect in next year's meeting. 

If you have questions or comments around the EASL Congress meeting, new nomenclature, discussed papers or any other ideas addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at [email protected].

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