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Prof. Dr. Jörn M. Schattenberg joins the Surfers to discuss his recent article in Expert Opinion on Investigational Drugs dissecting recent drug trial failures.

Prof. Dr. Jörn M. Schattenberg joins Stephen, Donna, Louise and Roger to discuss his recent article "The Nonalcoholic Steatohepatitis (NASH) drug development graveyard: established hurdles and planning for future successes." The discussion started with lessons from failed trials, focusing on the importance of utilizing Phase 2 trials to test hypotheses and establish appropriate targets. From there, Surfers went on to discuss commercial and patient-focused definitions of what makes a clinical trial successful.

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Stephen Harrison, Roger Green and our guest Surfer, Dr. Manal Abdelmalek, identify pivotally important presentations and posters from The Digital Liver Meeting 2020

SurfingNASH continues our AASLD coverage by asking Stephen Harrison, Roger Green, and guest Surfer Dr. Manal Abdelmalek to identify and review abstracts they consider important or uniquely interesting. The abstracts they chose focus on exciting new agents, the emerging role of #artificialintelligence (AI) and machine learning inpatient diagnostics, and several issues surrounding lean NASH. AI-guided patient-level diagnostics? The story that emerges: a world where patients are diagnosed earlier and treated with agents that drive rapid response. Better liver health, better treatment of the entire range of metabolic non-communicable diseases...very intriguing!

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Louise Campbell, Donna Cryer, and Naim Alkhouri identify pivotally important presentations and posters from The Digital Liver Meeting 2020.

SurfingNASH kicks off its AASLD coverage by announcing four of our seven KOL guest Surfers. One of them, Dr. Naim Alkhouri, participates via interview. Naim, Louise Campbell, and Donna Cryer identify abstracts they consider important or uniquely interesting. The abstracts they chose focus on population health (particularly juvenile and pediatric NASH) and the link between NASH, obesity, metabolic factors, and death due to cancer. The issue of treating pediatric and adolescent NASH is tremendously challenging with issues involving diagnosis (are biopsies in children a good idea?), new agent testing (is the benefit ration for clinical trials in adolescents and pediatrics worth the risk?), and social education (how and what do we teach families)? An important and thoughtful episode for healthcare providers as well as anyone interested in public health or forecasting future use of medications and diagnostics.

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Guest Surfer and regular listener Dr. Ian Rowe joins the Surfers to discuss how everyday patient treatment in the clinic once was and how COVID-19 and the news we discuss weekly on SurfingNASH have changed practice.

This week's Guest Surfer, Dr. Ian Rowe, devotes roughly half his time to treating patients in his Hepatology practice in Leeds, UK, and the other half on research and teaching issues. He joined the Surfers to discuss how patients were referred to his clinic and how he treated them before COVID-19, and how the demands of the pandemic have changed practices in the clinic. Not surprisingly, the conversation turned to the best way to use the diagnostics we have and how events of the past year have increased the productive focus on using better diagnostics while simultaneously using diagnostics better. Along the way, learn about a significant research effort (350,000 patient records!) Dr. Rowe and his colleague, Dr. Richard Parker have undertaken and why sequential use of multiple non-invasive tests may offer the winning strategy for improving patient treatment.

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On the six-month anniversary of SurfingNASH's first episode, the Surfers stop to consider how much has changed for NASH stakeholders since April

Thursday marks the six-month anniversary of SurfingNASH's first episode. The last six months have seen both setbacks and large steps forward in drug development, major advances in disease knowledge and increased breadth and depth of patient advocacy. The Surfers reflect on all these changes while remembering key steps in the podcast's evolution. Past guest Surfers Tony Villiotti of NASH kNOWledge and Suneil Hosmane of GenFit add their own reflections about what has changed.

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Matt Kelly, Chief Innovation Officer at Perspectum, Ltd., joins the Surfers to discuss early findings from the COVERSCAN study which looks at the relationship between COVID-19 infection and major end-organ systems.

Matt Kelly, Chief Innovation Officer at Perspectum, Ltd. joins the Surfers to discuss two studies that look at the relationship between COVID-19 and the liver. In the COVERSCAN study, Perspectum plans to conduct multi-organ scans of 500 patients who have recovered from a COVID-19 infection at two-time points: post-infection and six months later. The goal was to establish the impact of the COVID-19 infection on all the body's major organ systems. During this podcast, Matt discusses the results of the first round of scans on the first 200 patients. In the current UK BioBank analysis, UK BioBank culled through its database of 500,000 patients aged 40-75 to find 1,000 who had prior COVID-19 tests and imaging and compared the 10% of these patients who tested positive to the rest of the cohort. Both sets of results suggest a complicated relationship between fatty liver and severity of COVID-19 infection. This new research is producing eye-opening results that challenge conventional thinking. Perhaps our most important episode to date...


Browse Our NASH and COVID-19 Coverage https://surfingnash.com/covid-19/

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Stephen Harrison leads the Surfers through a review of FGF-21s and other exciting drug development news.

Stephen Harrison starts this week's discussion reviewing the recent announcement of a promising Phase 1b/2a study for 89bio-100 (link to slide deck below), an FGF-21 agent that demonstrated significant reductions on liver fat and had positive effects on other metabolic measures. The discussion broadened to address an array of issues: other agents in development; changing (higher) expectations for how these agents will affect PDFF and possibly fibrosis; possible directions for combination therapy; and the five clinical values that collectively tell us the impact new medications can have on overall liver and metabolic health. One Surfer described this as a "brilliant 20-minute review." 

89bio-slide deck: http://bit.ly/89bio-report

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The Surfers discuss four issues that are likely to affect how our thinking about NASH diagnosis, education, and treatment might evolve over the next three months.

Naim Alkhouri joins the Surfers to discuss some key NASH-related questions. The four key sections address upcoming clinical trials, steps forward in patient advocacy, the UK NCD report and need for patient education, and the pervasive impact of COVID-19 on how we think and talk about liver disease. Always lively, always provocative, and occasionally humorous, this episode is worth a long listen.

Browse Our NASH and COVID-19 Coverage https://surfingnash.com/covid-19/

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The Surfers discuss the Global Liver Institute's campaign to educate and motivate key stakeholder groups on the value of non-invasive liver testing.

Donna Cryer, President and CEO of the Global Liver Institute, discusses GLI's "Beyond the Biopsy" campaign while Stephen Harrison, Louise Campbell, and Roger Green join in with education, messages, and ideas. The "Beyond the Biopsy" campaign focuses on the importance of gaining acceptance for non-invasive liver testing. Stephen discusses why validation matters and why "H" is a magic letter. Roger discusses the history of statins and the importance of what appears on blood testing results. Louise discusses simple things that healthcare can do to diagnose and treat liver disease before it becomes deadly. An eye-opening episode!

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The Surfers and guest Joern Schattenberg consider the implications of a Digital ILC presentation stating that the liver, not cardiovascular disease, is the leading cause of death for NAFLD patients.

The Surfers considered the implication of a Digital ILC presentation by James Paik et al. titled "Causes of death in patients with non-alcoholic fatty liver disease (NAFLD): data from national vital statistics system (NVSS)." The presentation demonstrated that liver disease, not cardiovascular, is the leading cause of death for NAFLD patients, with broad implications for treating early-stage patients. Surfers asked: If NAFLD patients "feel bad" all the time, can patient-reported outcomes become a primary measure? Shouldn't metabolic measures remain vitally important for patients most of whom are obese and exhibit concomitant Type 2 diabetes or cardiovascular disease? And which test(s) provide the greatest support for FibroScan in demonstrating positive predictive value? A tremendous amount of content and tips from Dr. Harrison and Prof. Schattenberg. You'll want to listen more than once!