Surfing the MASH Tsunami

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Surfing NASH returns to its regular program with a fresh episode and some fascinating and progressive ideas around non-invasive testing. Mazen Noureddin joins co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to discuss serum identification of at-risk MASH and the Metabolomics-Advanced Steatohepatitis Fibrosis Score (MASEF). In late July, Mazen co-authored a paper on the subject which was published in Hepatology.

For this opening conversation, Mazen cogently introduces why and how MASEF came to exist as an emerging noninvasive test. He first notes the utility of the HbA1c test - one of the commonly used tests to diagnose prediabetes and diabetes and also the main test to assist health care teams manage diabetes - suggesting that hepatology could benefit from having something similar for risk stratification and disease identification. While not exactly comparable to having an HbA1c test for NAFLD, Mazen suggests this work with MASEF to be “a step in the right direction.” He then goes on to describe the research background and partnerships with an experienced metabolomics team before describing in further detail study parameters and notable findings. At the end of the session, Jörn inserts a question which clarifies the diversity of cohorts. Lastly, Mazen raises the idea that MASEF could be used alternatively to liver stiffness measurement by VCTE in the algorithm that is currently recommended by several guidance publications.

If you have questions or comments around MASEF, metabolomics or any other ideas considered 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]. The Surfing the NASH Tsunami will be back next week with more original content.

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This week, Surfing NASH returns to its regular program with a fresh episode and some fascinating and progressive ideas around non-invasive testing. Mazen Noureddin joins co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to discuss serum identification of at-risk MASH and the Metabolomics-Advanced Steatohepatitis Fibrosis Score (MASEF). Mazen co-authored a paper on the subject which was published in Hepatology as recent as late July. In a nutshell, this episode elucidates on developing and validating a highly specific metabolomics-driven score to identify at-risk MASH (metabolic dysfunction-associated steatohepatitis) patients.

Ultimately, the paper concludes MASEF to indeed be a promising diagnostic tool for the assessment of at-risk MASH. Specifically, it states that MASEF "could be used alternatively to liver stiffness measurement by VCTE in the algorithm that is currently recommended by several guidance publications." Listen to the Surfers respond with their thoughts, questions and varying perspectives. 

If you have questions or comments around MASEF, metabolomics or any other ideas considered 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]. The Surfing the NASH Tsunami will be back next week with more original content.

Stay Safe and Surf On!

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Last week SurfingNASH offered a final re-focus on an episode that originally aired during Season 1. Continuing on the focus around allied health, this session dives into the role of nurses, physicians and allied health professionals in supporting NASH patients - a topic of increasing relevance as the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals. Specifically, the group explores whether healthcare systems can be as effective as companies like Noom and WeightWatchers.

If you have questions or comments around our From the Vault series, allied health, education 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]. The Surfing the NASH Tsunami will be back next week with more original content.

Stay Safe and Surf On!

Send us Fan Mail

Last week SurfingNASH offered a final re-focus on an episode that originally aired during Season 1. Continuing on the focus around allied health, this session dives into the role of nurses, physicians and allied health professionals in supporting NASH patients - a topic of increasing relevance as the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals. Specifically, the group explores whether healthcare systems can be as effective as companies like Noom and WeightWatchers.

This conversation starts with Louise agreeing enthusiastically with Stephen's comments around keeping things simple. Roger asks Stephen and Louise how often we believe the treater should see the patient. They each answer that three months seems to be the right visit frequency and discuss what they consider important elements for that visit. Peter notes that the COVID pandemic is teaching us that visits can occur by video call, which reduces the cost for each visit in terms of money to health care system and time to the practitioner. Roger shares some of what he has learned as a patient who has lost significant amounts of weight on three occasions in his life. Roger finishes his comments by asking whether the formal health care system should take greater advantage of weekly and biweekly online assistance programs like Noom, which was in a dramatic growth spurt during the early days of the pandemic. Louise closes this conversation by agreeing that this idea has value.

If you have questions or comments around our From the Vault series, allied health, education 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]. The Surfing the NASH Tsunami will be back next week with more original content.

Stay Safe and Surf On!

Send us Fan Mail

Last week SurfingNASH offered a final re-focus on an episode that originally aired during Season 1. Continuing on the focus around allied health, this session dives into the role of nurses, physicians and allied health professionals in supporting NASH patients - a topic of increasing relevance as the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals. Specifically, the group explores whether healthcare systems can be as effective as companies like Noom and WeightWatchers.

Louise start this conversation by agreeing with Peter's comment about the importance of team care and discusses what worked and what didn't work in the liver practice at the NHS when she was there. Peter and Roger each make comments about how to advance team treatment and Stephen shares the perspective of "a passionate provider" and discusses some of his tactics for motivating patients citing two recent cases in detail.

If you have questions or comments around our From the Vault series, allied health, education 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]. The Surfing the NASH Tsunami will be back next week with more original content.

Stay Safe and Surf On!

Send us Fan Mail

Last week SurfingNASH offered a final re-focus on an episode that originally aired during Season 1. Continuing on the focus around allied health, this session dives into the role of nurses, physicians and allied health professionals in supporting NASH patients - a topic of increasing relevance as the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals. Specifically, the group explores whether healthcare systems can be as effective as companies like Noom and WeightWatchers.

This fascinating conversation features ideas shared by Stephen Harrison, Peter Traber (Chief Medical Officer at Selecta Biosciences ), Louise Campbell and Roger Green. Roger begins by framing the discussion around three questions:

1) For allied professionals how much of their focus lies in maintaining and enhancing wellness as compared to treating illness?

2) How do these two concepts differ both in the minds of professionals and in terms of what information and guidance they present to patients?

3) What are the keys in supporting patients' focus on wellness, both during the office visit and afterwards?

Louise responds based on her own experience as she recently moved out of the NHS to focus on more early stages of the disease, where it's ultimately easier to change behavior and encourage wellness and preventative practices in general. Louise connects the idea that liver patients tend not to get information until later in their disease to the announcement that the British government made on creating a far reaching policy around obesity and its likely impact on patient health. In response to one of the questions from Roger, Louise goes on to discuss how we present information in ways that empower patients to take better care of themselves. Done right, this can extend beyond the individual patients and to their families and other supporters. Peter agrees and comments based on his own past experiences in medical practice. He notes that patients have extensive care teams with multiple areas of expertise and patients are best served when the care team members actually act as a team (keeping in mind especially that 2020 was mid-pandemic).

If you have questions or comments around our From the Vault series, allied health, education 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]. The Surfing the NASH Tsunami will be back next week with more original content.

Stay Safe and Surf On!

Send us Fan Mail

This week SurfingNASH continues to offer a final re-focus on an episode that originally aired during Season 1. Similar to last week's focus on allied health, this session dives into the role of nurses, physicians and allied health professionals in supporting NASH patients - a topic of increasing relevance as the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals. Specifically, the group explores whether healthcare systems can be as effective as companies like Noom and WeightWatchers. The fascinating conversation features ideas and critical concepts shared by Stephen Harrison, Peter Traber (Chief Medical Officer at Selecta Biosciences ), Louise Campbell and Roger Green.

If you have questions or comments around our From the Vault series, allied health, education 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]. The Surfing the NASH Tsunami will be back next week with more original content.

Stay Safe and Surf On!

Send us Fan Mail

SurfingNASH is offering something different for Season 4, Episode 37 while the co-hosts are off enjoying a well-deserved holiday amid a busy year. Rather than leaving a gap in the podcast's program, this week we are revisiting an episode From the Vault that, now more than ever, maintains its relevance. As the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals, education and educational resources are critically needed. This session, led by Louise Campbell, focuses on the roles that allied health can play in prevention, early stage management and clinical trial recruitment for NAFLD/NASH. Allied health is our primary interface for the education and support within the clinical setting of patients with any disease. Allied health professionals are a vastly experienced resource supporting both physicians and patients in the delivery of care and efficacy. Stephen Harrison also joins Louise and guest panelists (Kathryn Jack, Michele Clayton, Pam O’Donoghue and Patrizia Kunzler) to consider the many ways that liver nurses and advanced nursing practitioners can do more to support NASH education and patient management and where they should fit into the paradigm. This conversation explores the need for and value of patient education in the NASH Patient Care process. It starts with almost a tangential request that some of the money budgeted for expensive systemic HCC therapies in the UK be rededicated to patient education earlier in the treatment process. From there, the conversation shifts to consider the value of the need for early-stage treatment strategies in poorer countries that are never likely to be able to afford the expense of drugs or treatment modalities. In the end, each panelist describes a change she would like to see in the next 2-3 years.

If you have questions or comments around our From the Vault series, allied health, education 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].

Stay Safe and Surf On!

Send us Fan Mail

SurfingNASH is offering something different for Season 4, Episode 37 while the co-hosts are off enjoying a well-deserved holiday amid a busy year. Rather than leaving a gap in the podcast's program, this week we are revisiting an episode From the Vault that, now more than ever, maintains its relevance. As the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals, education and educational resources are critically needed. This session, led by Louise Campbell, focuses on the roles that allied health can play in prevention, early stage management and clinical trial recruitment for NAFLD/NASH. Allied health is our primary interface for the education and support within the clinical setting of patients with any disease. Allied health professionals are a vastly experienced resource supporting both physicians and patients in the delivery of care and efficacy. Stephen Harrison also joins Louise and guest panelists (Kathryn Jack, Michele Clayton, Pam O’Donoghue and Patrizia Kunzler) to consider the many ways that liver nurses and advanced nursing practitioners can do more to support NASH education and patient management and where they should fit into the paradigm. This conversation explores the different challenges that liver nurses and advanced practitioners face when providing NASH patient education. It starts with Stephen noting that this weeks’ reported results from Madrigal’s MAESTRO-NAFLD Phase 3 trial promises a day when we can reduce HCC and cirrhosis if we can counsel patients early enough in the process. From there, the conversation shifts to consider the different specialties that can play a role, including not only hepatologists and nurses but also podiatrists, bariatricians, endocrinologists, and gynecologists. The rest of the conversation covers an array of prospective educational tools and the need for specific education that hits specific key points.

If you have questions or comments around our From the Vault series, allied health, education 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].

Stay Safe and Surf On!

Send us Fan Mail

SurfingNASH is offering something different for Season 4, Episode 37 while the co-hosts are off enjoying a well-deserved holiday amid a busy year. Rather than leaving a gap in the podcast's program, this week we are revisiting an episode From the Vault that, now more than ever, maintains its relevance. As the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals, education and educational resources are critically needed. This session, led by Louise Campbell, focuses on the roles that allied health can play in prevention, early stage management and clinical trial recruitment for NAFLD/NASH. Allied health is our primary interface for the education and support within the clinical setting of patients with any disease. Allied health professionals are a vastly experienced resource supporting both physicians and patients in the delivery of care and efficacy. Stephen Harrison also joins Louise and guest panelists (Kathryn Jack, Michele Clayton, Pam O’Donoghue and Patrizia Kunzler) to consider the many ways that liver nurses and advanced nursing practitioners can do more to support NASH education and patient management and where they should fit into the paradigm. This conversation explores the different challenges that liver nurses and advanced practitioners face when providing NASH patient support. It focuses on issues including health discrimination, the general challenges in deploying nursing care early in the disease progression and the mismatch of needs and resources. In the end, we learn about nurses who make their own recordings and encourage patients to create their own discussion groups in the medical office.

If you have questions or comments around our From the Vault series, allied health, education 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].

Stay Safe and Surf On!