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Late last week, AASLD published new practice guidance on the clinical assessment and management of NAFLD. To explore its key features and implications, the surfers convene with Ken Cusi, who contributed to the previous iteration published in 2018. The updated document reflects the many advances pertinent to any practitioner caring for patients with NAFLD. Notably, and as detailed in this episode, it emphasizes advances in noninvasive risk stratification and therapeutics. The group covers at-depth a range of topics to underscore the basis of progress in the field while offering compelling insights on the emerging path forward in combating Fatty Liver diseases.

Among a plethora of other discussion points unpacked, the panelists expand on the following major themes:

06:21

Roger Green opens by asking Ken to highlight how a Guidance differs from a Guideline. Ken goes on to provide a robust introduction that contextualizes this publication and states "a lot has happened in five years." Jörn Schattenberg and Louise Campbell follow with their initial impressions, each commending what they describe as an excellent framework for moving the field forward. 

15:24

The panelists dive into the guidance’s account of using biomarkers and NITs to either exclude advanced disease or identify those with a high probability of cirrhosis. They focus mainly on the utility of FIB-4 and the dynamics of ALT cut points. Louise comments on the universal importance of including AST and ALT in blood profiles. 

24:01

Conversation shifts toward the impact this guidance may have on patients: will it make a difference and if so, how? Ken outlines options for treating patients today and drives a critical message: “the time is now.” 

31:39

Jörn and Louise discuss what sort of impact the AASLD guidance may have outside of the US. While Jörn notes the utility of this document for developing EASL guidelines, Louise is wary that NICE will remain restricted to referencing data obtained exclusively within the UK. 

38:15

As the session winds down, Roger announces that Ken will be co-hosting a new podcast series with him. The NASH Tsunami in Diabetes: Getting Ahead of the Rising Tide is tailored for healthcare professionals who treat diabetic patients, the patients themselves and their caregivers. Finally, Roger returns to one last question centered around the guidance: how will this shape progress in coming years?


If you enjoy this episode or have questions on the new guidance, we kindly ask that you submit reviews wherever you download our discussions. Alternatively, you can write us directly at [email protected]. We also encourage our audience to explore more on the Rising Tide series before it airs next week. Most important of all, we whole-heartedly thank you for your continued support as we set out to put a major dent in Fatty Liver disease in 2023 and beyond.


Stay safe and surf on!