Surfing the MASH Tsunami

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In a monumental moment for combatting Fatty Liver disease, NICE has published the much anticipated evidence-based recommendations on FibroScan for assessing liver fibrosis and cirrhosis outside secondary and specialist care. Such a positive announcement comes at no better time than during the Surfing NASH  coverage of International #NASHDay 2023 . This conversation features hepatology researcher and KOL, William Alazawi, and new guest Vanessa Hebditch who serves as Director of Communications and Policy at the British Liver Trust. The panelists, alongside Louise Campbell and Roger Green, celebrate and comment on the new guidance on FibroScan use in the UK.

This conversation starts with Roger providing a brief background on the Surfing NASH coverage of the NICE-FibroScan question. Vanessa is invited to share the work that her organization has done on this issue. She starts by describing the obligation that NICE has to take feedback from multiple stakeholders. She details a 16-month history of the discussion around this issue and the British Liver Trust's role in it. In the process, Vanessa elaborates on the value of anecdotes and patient-centered data in persuading NICE committees to think more expansively about the value of FibroScan and facilitating an alliance of professional societies in support of this campaign. Louise notes how revisions in data and models coupled with new perspectives led to a change in the NICE vision over time and produced this result. Will discusses the value of FibroScan and preventive hepatology, asserting that the level and nature of necessary data to prove the value of this intervention does not yet exist. He says that at the same time advocates promote use, these same stakeholders should "put our feet to the fire to produce evidence that will support the activity." Louise agrees and notes that the protocols will require those doing the scans to be trained and then assessed to assure quality. Finally, she agrees with Will that the stakeholders need to collect data from all locations to assure quality and that no such process exists today. Roger points out that previously on the podcast, Jeff Lazarus reported back in 2021 that the UK scored higher than any other country in its preparation for the NASH pandemic. Although it scored only 50 points on a 100-point scale, the joint NICE Guidance and NHS Funding initiative have the potential to boost that score significantly and start to build a demonstration model for other countries. Done right, it's an exciting, albeit challenging prospect.

If you have questions or interest around NICE and FibroScan use, 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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Thursday, June 8 was International #NASHDay 2023 and the podcast hosted a special session featuring patient advocates Gina Villiotti Madison (NASH kNOWledge), Marko Korenjak (European Liver Patients'​ Association) and Michael Betel (Fatty Liver Alliance). With co-hosts Louise Campbell and Roger Green, the group shares both a positive and sobering discussion around the Fatty Liver public health epidemic and its impact on younger generations now and into the imminent future.

Roger starts this conversation by asking Louise to provide more information about the U.K. Parliament debate that had just commenced. Louise notes that MPs from all parts of the UK participated and that they were extremely well-informed on childhood NAFLD and other issues. She notes that members told stories of their own weight loss and government promise to brief MPs on liver disease on an interim basis going forward. One MP said he did not like the term living with obesity, which is considered patient sensitive, because it implies that obesity is a permanent condition. This leads to Roger's closing question which asks each panelist to envision what their organizations' key 2024 International #NASHDay activities might be. While their answer are aligned with what they did for the International #NASHDay 2023, listen for some different twists and new directions.

This is a particularly important and moving episode that captures a range of topics pertinent to the patient perspective and, more broadly, stepping up to NASH. If you have questions or interest around the International #NASHDay 2023, we kindly ask that you submit reviews wherever you download our discussions. Alternatively, you can write to us directly at [email protected]. We welcome all stories around how you and your community stepped up to NASH this year and look forward to broadening the discourse.

Stay Safe and Surf On!

This episode was generously sponsored by Madrigal Pharmaceuticals.
Madrigal Pharmaceuticals, Inc. is a clinical-stage biopharmaceutical company pursuing novel therapeutics for nonalcoholic steatohepatitis (NASH), a liver disease with high unmet medical need. Madrigal’s lead candidate, resmetirom, is a once daily, oral, thyroid hormone receptor (THR)-β selective agonist designed to target key underlying causes of NASH in the liver. For more information, visit www.madrigalpharma.com. 

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Thursday, June 8 was International #NASHDay 2023 and the podcast hosted a special session featuring patient advocates Gina Villiotti Madison (NASH kNOWledge), Marko Korenjak (European Liver Patients'​ Association) and Michael Betel (Fatty Liver Alliance). With co-hosts Louise Campbell and Roger Green, the group shares both a positive and sobering discussion around the Fatty Liver public health epidemic and its impact on younger generations now and into the imminent future.

Roger starts this conversation by asking the panel about other groups and organizations each is working to reach in an effort to increase education and awareness. The first observations revolve around efforts in the UK to take FibroScan into the public domain based on NHS funding of community centers and the NICE guidance about the economic value of FibroScan use outside of the specialist clinics and in primary settings. Louise believes that this will improve frontline patient education with the FibroScan scores and offer an opportunity to educate and motivate people who want to know their liver health. She mentions Naim Alkhouri's discussion of FibroScan as the fifth vital sign in his discussion with Donna Cryer as part of International #NASHDay. Louise then amplifies on her dialogs and opportunities she sees with patients she scans today. Roger asks about the socioeconomic status of the people she scans. She notes that her patients are higher in socioeconomic status and patients who are lower on socioeconomic status tend to have more disease. She questions whether this is solely about diet or also about the far broader opportunities that higher socioeconomic status patients have to active lifestyles. Gina comments that she encounters lots of people who are unaware of the true caloric contents of their diets, especially in terms of sugar intake. She also notes that ultra-processed foods are far more affordable than organic fresh produce, for example. Eventually, Gina discusses how sugar in drinks can contribute to a public health epidemic unrecognized by many parents. As the conversation winds down, Roger asks Marko about the different activities he sees in the 30 EU countries that ELPA represents. He talks about a walking and learning program in Cyprus among other activities. Finally, he pinpoints the ages between 18 to 35 as the key years to adopt good habits.

This is a particularly important and moving episode that captures a range of topics pertinent to the patient perspective and, more broadly, stepping up to NASH. If you have questions or interest around the International #NASHDay 2023, we kindly ask that you submit reviews wherever you download our discussions. Alternatively, you can write to us directly at [email protected]. We welcome all stories around how you and your community stepped up to NASH this year and look forward to broadening the discourse.

Stay Safe and Surf On!

This episode was generously sponsored by Madrigal Pharmaceuticals.
Madrigal Pharmaceuticals, Inc. is a clinical-stage biopharmaceutical company pursuing novel therapeutics for nonalcoholic steatohepatitis (NASH), a liver disease with high unmet medical need. Madrigal’s lead candidate, resmetirom, is a once daily, oral, thyroid hormone receptor (THR)-β selective agonist designed to target key underlying causes of NASH in the liver. For more information, visit www.madrigalpharma.com. 

Send us Fan Mail

Thursday, June 8 was International #NASHDay 2023 and the podcast hosted a special session featuring patient advocates Gina Villiotti Madison (NASH kNOWledge), Marko Korenjak (European Liver Patients'​ Association) and Michael Betel (Fatty Liver Alliance). With co-hosts Louise Campbell and Roger Green, the group shares both a positive and sobering discussion around the Fatty Liver public health epidemic and its impact on younger generations now and into the imminent future.

In this conversation, the group focuses discussion around adolescent NAFLD/NASH. Roger begins by mentioning how the way his generation grew up involved ample time outdoors playing. He goes on to note two differences between then and now. First, the perception that outside areas are not as safe as they once were. Second, Roger underscores the rise of indoor video and online games that occupy the time and attention of children today. Roger asks whether and how we can reverse this trend, particularly when it involves different parents who might work 10 to 12 hours a day. Louise suggests this will be difficult because while outdoor play is no less safe than in past decades, social media has increased the fear that children are unsafe outdoors. After the group jokes about how the presence of wireless television remotes contributed to less active lifestyles, Roger comments on how news cycles operate in the US today.

Michael discusses the role of governments in improving information on food labelling. This leads Gina to note that as a mother, it was only recently that she realized the extent of the health challenges presented by the food her children were eating both at home and at school. She goes on to describe how and why NASH kNOWledge focuses so much attention on children.  One idea is that educating children is an excellent way of transmitting information to the entire family. Gina cites the success of public service advertising on school education at getting children to talk with their parents about quitting smoking in past years. It's her hope that we can achieve the same benefits regarding food and exercise. Tune into the subsequent conversations to listen to more comments around sugar intake.

This is a particularly important and moving episode that captures a range of topics pertinent to the patient perspective and, more broadly, stepping up to NASH. If you have questions or interest around the International #NASHDay 2023, we kindly ask that you submit reviews wherever you download our discussions. Alternatively, you can write to us directly at [email protected]. We welcome all stories around how you and your community stepped up to NASH this year and look forward to broadening the discourse.

Stay Safe and Surf On!

This episode was generously sponsored by Madrigal Pharmaceuticals.
Madrigal Pharmaceuticals, Inc. is a clinical-stage biopharmaceutical company pursuing novel therapeutics for nonalcoholic steatohepatitis (NASH), a liver disease with high unmet medical need. Madrigal’s lead candidate, resmetirom, is a once daily, oral, thyroid hormone receptor (THR)-β selective agonist designed to target key underlying causes of NASH in the liver. For more information, visit www.madrigalpharma.com. 

Send us Fan Mail

Thursday, June 8 was International #NASHDay 2023 and the podcast hosted a special session featuring patient advocates Gina Villiotti Madison (NASH kNOWledge), Marko Korenjak (European Liver Patients'​ Association) and Michael Betel (Fatty Liver Alliance). With co-hosts Louise Campbell and Roger Green, the group shares both a positive and sobering discussion around the Fatty Liver public health epidemic and its impact on younger generations now and into the imminent future.

This conversation starts with Roger asking each of panelist to describe the activities that their organizations have undertaken as part of International #NASHDay. Gina leads by talking about two of her organization's activities in the Pittsburgh area. First, the NASH kNOWledge released a video playing on the theme of Step Up for NASH. The fun video features simple dance steps and routines by organization leaders and volunteers. Second, NASH kNOWledge sponsored an event Thursday evening focused on the Hispanic community, where NAFLD is significant and under-managed disease. Gina goes on to discuss the organization's overall commitment to the Hispanic community.

Michael discusses the range of interviews he has been doing with major organizations as well as an in-person event Thursday night in the Ottawa area. On Saturday, Fatty Liver Alliance plans a full day community event. Marko next notes that ELPA decided to make June a Fatty Liver Month initiative triggered by multiple online posts designed to get the attention of leaders throughout the European Union. On International #NASHDay ELPA held an event at the EU parliament in Brussels with patients and speakers from ten different countries. Marko closes his comments by noting that when ELPA talks to parliament members about adult NAFLD, they are far less interested than when he ELPA discusses a childhood disease. This leads Roger to ask whether talking about children is a motivator to legislators and key figures in other countries, and if so, why? As the conversation winds down, Louise discusses motivations in the UK built around projections of declining life expectancy, coupled with the fact that 39% of obese UK patients have an NAFLD. The rest of the panelists follow by sharing their own perspectives which align with Roger's observation and Louise's comments. 

This is a particularly important and moving episode that captures a range of topics pertinent to the patient perspective and, more broadly, stepping up to NASH. If you have questions or interest around the International #NASHDay 2023, we kindly ask that you submit reviews wherever you download our discussions. Alternatively, you can write to us directly at [email protected]. We welcome all stories around how you and your community stepped up to NASH this year and look forward to broadening the discourse.

Stay Safe and Surf On!

This episode was generously sponsored by Madrigal Pharmaceuticals.
Madrigal Pharmaceuticals, Inc. is a clinical-stage biopharmaceutical company pursuing novel therapeutics for nonalcoholic steatohepatitis (NASH), a liver disease with high unmet medical need. Madrigal’s lead candidate, resmetirom, is a once daily, oral, thyroid hormone receptor (THR)-β selective agonist designed to target key underlying causes of NASH in the liver. For more information, visit www.madrigalpharma.com.

Send us Fan Mail

Thursday, June 8 was International #NASHDay 2023 and the podcast hosted a special session featuring patient advocates Gina Villiotti Madison (NASH kNOWledge), Marko Korenjak (European Liver Patients'​ Association) and Michael Betel (Fatty Liver Alliance). With co-hosts Louise Campbell and Roger Green, the group shares both a positive and sobering discussion around the Fatty Liver public health epidemic and its impact on younger generations now and into the imminent future. Each guest discusses what their respective organizations are doing in support of International #NASHDay and the conversations that follow invoke a sense of urgency to take action as a community. This is a particularly important and moving episode that captures a range of topics pertinent to the patient perspective and, more broadly, stepping up to NASH.

If you have questions or interest around the International #NASHDay 2023, we kindly ask that you submit reviews wherever you download our discussions. Alternatively, you can write to us directly at [email protected]. We welcome all stories around how you and your community stepped up to NASH this year and look forward to broadening the discourse.

Stay Safe and Surf On!

This episode was generously sponsored by Madrigal Pharmaceuticals.
Madrigal Pharmaceuticals, Inc. is a clinical-stage biopharmaceutical company pursuing novel therapeutics for nonalcoholic steatohepatitis (NASH), a liver disease with high unmet medical need. Madrigal’s lead candidate, resmetirom, is a once daily, oral, thyroid hormone receptor (THR)-β selective agonist designed to target key underlying causes of NASH in the liver. For more information, visit www.madrigalpharma.com.

Send us Fan Mail

In a monumental moment for combatting Fatty Liver disease, NICE has published the much anticipated evidence-based recommendations on FibroScan for assessing liver fibrosis and cirrhosis outside secondary and specialist care. Such a positive announcement comes at no better time than the start of the Surfing NASH  ongoing coverage of International #NASHDay 2023 . To kick off the occasion, this first episode features hepatology researcher and KOL, William Alazawi, and new guest Vanessa Hebditch who serves as Director of Communications and Policy at the British Liver Trust. The panelists, alongside Louise Campbell and Roger Green, celebrate and comment on the new guidance on FibroScan use in the UK.

In addition, stay tuned for a session dedicated to International #NASHDay 2023 which will be released on Friday June 9th. If you have questions or interest around the event or FibroScan use, 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!

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On May 6 and 7 2022, over 100 NAFLD stakeholders convened in Barcelona and on-line for the inaugural Innovations in NAFLD Care 2022 conference (#INCBCN.) Surfing the NASH Tsunami was there, with Jörn Schattenberg serving as event co-chair and Louise Campbell and Roger Green moderating sessions. This episode From the Vault is less a formal recap of the meeting than recollections of key moments and messages from the co-founders and Surfers.

This discussion starts with #INCBCN co-founder Jeff Lazarus and Roger Green what Jeff considered the successes and surprises of the conference. Jeff speaks about the “palpable” energy of the attendees, the number of people who attended virtually and engaged through Q & A and the range of issued addressed at the conference as three strong positives. On a more prosaic note, he also mentions how well the technology worked throughout the meeting. Roger Green suggests that much of the energy came from merging three separate streams of activity — medical specialists, primary care and patient advocates — into a single conversation that touched on all three groups’ issues. He also suggests that having Marcus Ranney and Jeff to share a digital health vision of the future added additional energy and the prospect of what Roger calls “radical patient empowerment.” As co-founder Jörn Schattenberg and then Louise Campbell join the conversation, levity ensues as the four discuss the surprise closing statement from Jeff and Jörn and then a more serious tone as the group discusses the benefits that multidisciplinary conversation brought to all the participants.

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Surfing NASH returns to review the 2023 Innovations in NAFLD Care Workshop (INCBCN) which concluded on 27 May in Barcelona. Conference founders and directors Jeff Lazarus and Jörn Schattenberg discuss highlights and takeaways of the event with Louise Campbell and Roger Green.

This closing conversation continues to cover the highlights of the second day,  including the EU Pearl program and the debate about the value of curing NAFLD and NASH with a vegetarian diet or not. The session goes on to capture final thoughts and ideas which will be carried over into future programs. Listen on to hear each respond to a set of closing questions around a truly unique and innovative program.

If you have questions or interest around the Innovations in NAFLD Care Workshop 2023, we kindly ask that you submit reviews wherever you download our discussions. Alternatively, you can write to us directly at [email protected].

Stay Safe and Surf On!

Send us Fan Mail

Surfing NASH returns to review the 2023 Innovations in NAFLD Care Workshop (INCBCN) which concluded on 27 May in Barcelona. Conference founders and directors Jeff Lazarus and Jörn Schattenberg discuss highlights and takeaways of the event with Louise Campbell and Roger Green.

This conversation starts with Jeff commenting on patient needs and a specific question which Alina Allen raised around whether people should be diagnosed earlier and do the harms outweigh the benefits? Jeff notes that this is a significant mistake, recalling his own experiences with the Hep-C community. The group next detours briefly into the impact that the FDA ADCOM on obeticholic acid has on all of these issues before shifting to discuss the second day. Jörn talks about the idea that while there were a limited number of posters at the meeting, the posters that were there were excellent and engaging in the way that researchers could discuss them in detail. Jeff summarizes Alina Allen's talk about how to use AI and diagnostics. Jörn points out that we need more standardized patient reports if we were to use this data in AI because the data has to be standardized to take advantage of it. The end of the session takes an entertaining twist, so listen on to find out more.

If you have questions or interest around the Innovations in NAFLD Care Workshop 2023, we kindly ask that you submit reviews wherever you download our discussions. Alternatively, you can write to us directly at [email protected].

Stay Safe and Surf On!