Surfing the MASH Tsunami

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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 conversation revolves around the term preventive hepatology which was the focus of a roundtable. Roger asks whether taking a FibroScan into the community qualifies as preventive hepatology. Jörn suggests it might so long as the patient is properly identified. Jeff identifies one of the earliest papers on preventive hepatology from 2008 titled Minimizing symptoms and optimizing care. He goes on to promote the idea that the process of prevention needs to start earlier. This leads Roger to point to a moment of constructive disagreement in the meeting. He suggests that preventive hepatology needs to actually start before the patient ever gets to the hepatologist. Jeff mostly agrees and notes that on one level it all starts with Sustainable Development Goals outlined by WHO. Louise describes the idea that preventive hepatology is about more than the liver alone which leads Roger to throw out the term preventative metabolic health. Jörn suggests this to be an excellent ideal, but in a siloed health system we have to start by bringing disciplines together to break down those silos as INCBCN is designed to do.

As the session winds down, the group comments on the endocrinology session that Rising Tide co-host Ken Cusi chaired. The audience enjoyed seeing how these endocrinologists are focused on fatty liver disease with what Jörn describes as a practical view on extending liver care and management.

Listen on to discover the details revealed in the full episode. 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].

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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 conversation starts with a focus on the opening session which is titled The Fatal Triple and End-Organ Injury. Embedded in the recap is the topic of alcohol consumption and how it contributes to Fatty Liver disease. The idea emerges that a standard unit of drink varies in definition and that there may be benefit to gathering structured consensus on the definition. The second part of this conversation considers facilitating FibroScan testing in different patient settings.

Listen on to discover the details revealed in the full episode. 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].

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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 conversation captures the meeting in a broad sense by outlining its goals and reason for being. Jeff describes this year’s emphasis on expanding the community of practice beyond hepatology. For example, friend of the podcast and co-host of our Rising Tide series, Ken Cusi, chaired a session on the role of endocrinology and diabetology in the early diagnosis and management of NASH. In Jeff’s words, “We were trying to look at the liver more holistically and look at who else should be involved in a multidisciplinary approach.”

The discussion shifts to a review of the NASH-NITs Real-World-Evidence Summit. Jörn suggests that moving forward, the Summit ought to be expanded and broadened. After Jörn comments on the positive experience of facilitating hands-on engagement, Louise offers her take. She underscores that FibroScan testing requires adequate knowledge and training to be well-executed with precision. The group goes on to describe in detail what made the Summit unique and how it might grow in the future.

Listen on to discover the details revealed in the full episode. 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].

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Surfing NASH returns to review the second 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.

00:00 Introduction

06:14 Holistic thinking and expanding the community of practice

08:00 NASH-NIT Real World Evidence Summit

09:48 Louise on FibroScan proficiency

15:02 The Fatal Triple

18:52 Alcohol consumption and consensus around standards of drink

24:12 Exploring ideas of preventative hepatology

31:38 Session 2: Endocrinology and Diabetology in the early diagnosis and management of NASH

35:43 Poster presentations

37:02 Session 3: NAFLD Diagnostics

40:42 Session 4: NAFLD Treatment and Care

47:13 Closing question: any surprising audience responses?

Listen on to discover the details as revealed in the full episode. 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].

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The first three days of the 2022 program focused on a range of issues, with specific emphasis on non-invasive tests (NITs) and their role at different stages in diagnosis and treatment. This conversation From the Vault touches on two issues: use of AI to better understand the meaning of liver volume and elements of morphology and, relatedly, how much more sophisticated a view we take of NAFLD and NASH than we did even five years ago.

The issues around AI and liver morphology arise from Jörn Schattenberg’s comment that consistent with Stephen Harrison’s “KISS” (Keep It Simple, Stupid!) principle, researchers are starting to explore the meaning of changes in liver volume. Ultimately, Jörn notes, pairing these kinds of measures to AI-supported histopathology can yield tremendous benefits. Roger comments on a breakfast he attended that morning that suggested that AI and NITs each provide different, important information on individual liver health: NITs can address collagen burden but not structure, while AI can identify changes in structure but not link them to the impact on the patient. Zobair ends this part of the conversation by noting that companies are starting to use AI in these ways.

The second part of this conversation stems from Roger’s observation that we know far more about the disease than we did 3-4 years ago. He goes on to describe how the environment is more collaborative and open-minded than it might have been if, in fact, we saw drug approvals at that time. Zobair takes this observation to a different plane, noting that 5-10 years ago, “some very important experts” believed that we all understood the etiology of Fatty Liver disease, so why spend more time? He goes on, “we could not have been more wrong,” observing that what we have learned about progression and regression in placebo arms suggests a far more complex disease than something that progresses linearly, or even constantly in one direction. He goes on to add that the multiple drug trial failures is that targeting drugs to a single solution based on animal models is likely to fail because this is a multiple mode of action disease. His third point: the “source” of the disease is visceral obesity and insulin resistance, which all viable solutions must address. This identifies two targets for treatment, while simultaneously demonstrating that therapy will be chronic, lifelong and with behavioral elements. The rest of the conversation addresses the challenges with shaping this kind of lifelong, multitarget therapy in the US today.

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Surfing NASH offers an exciting preview of EASL Congress 2023 with new guest and EASL Vice-Secretary, Aleksander Krag, alongside EASL Educational Councillor, Sven Francque, and Surfers Jörn Schattenberg, Louise Campbell and Roger Green. The world’s largest liver meeting takes place 21-24 June in Vienna with an international faculty of experts from over 200 institutions. The diverse program will feature 2500 abstracts and be a uniquely momentous occasion for developing multidisciplinary approaches aimed at putting a major dent in Fatty Liver disease.

This final session starts with Roger sharing his appreciation for conversational opportunities that emerge from poster presentations at major meetings. The other panelists agree in their own ways that the presentations produce invaluable dialogue to bridge researchers and students over emerging science. From here, the conversation considers what about the virtual component of this meeting is unique and worth attending before moving on to final thoughts. Each recaps their excitement at a high level from differing perspectives and points of interest. Surf on to find out what they are.

If you enjoy the episode, have questions or interest around EASL Congress 2023 and Fatty Liver disease, 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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Surfing NASH offers an exciting preview of EASL Congress 2023 with new guest and EASL Vice-Secretary, Aleksander Krag, alongside EASL Educational Councillor, Sven Francque, and Surfers Jörn Schattenberg, Louise Campbell and Roger Green. The world’s largest liver meeting takes place 21-24 June in Vienna with an international faculty of experts from over 200 institutions. The diverse program will feature 2500 abstracts and be a uniquely momentous occasion for developing multidisciplinary approaches aimed at putting a major dent in Fatty Liver disease.

This conversation starts with Roger’s question to Sven around his role as Educational Councillor and the various educational opportunities embedded within the program. Sven first describes a postgraduate course that focuses on the link between NAFLD and cancer. He goes on to describe a plethora of activities which each embody different levels of education and participation for different stakeholder groups. Notably, he underscores the goal of broadening education to reach parties external to specialist hepatology groups. This is not only about raising awareness, but also engaging communities with the concept of liver health from a very young age. Roger asks what the balance is between virtual and onsite attendance and Aleksander suggests people are trending back to onsite participation. The group discusses why in-person attendance is especially positive for the previously described educational elements. From here Roger asks Aleksander and Sven for their lists of “3 things you can’t miss” for different participating groups. First, he asks what’s not to be missed for a recently minted transplant hepatologist. Next, he shifts focus to what’s not to be missed for attending students.

The conversation shifts to questions from Louise and Jörn which focus on how the program was put together. It becomes clear that this is a multifaceted event that combines the experiences of education, networking, science development and much more. Aleksander likens the meeting to a giant dinner party whereby the organizers are chefs who have taken a year to prepare an extravagant meal for thousands to enjoy. For the remainder of the session, Louise leans in on a comment Aleksander makes about allied health and points out that there are some very good and important sessions around health literacy.

If you enjoy the episode, have questions or interest around EASL Congress 2023 and Fatty Liver disease, 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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Surfing NASH offers an exciting preview of EASL Congress 2023 with new guest and EASL Vice-Secretary, Aleksander Krag, alongside EASL Educational Councillor, Sven Francque, and Surfers Jörn Schattenberg, Louise Campbell and Roger Green. The world’s largest liver meeting takes place 21-24 June in Vienna with an international faculty of experts from over 200 institutions. The diverse program will feature 2500 abstracts and be a uniquely momentous occasion for developing multidisciplinary approaches aimed at putting a major dent in Fatty Liver disease.

This conversation begins with Jörn describing his anticipations for the meeting where he will be Chair of two separate sessions. One such session of interest will be in the context of a Meet the Experts panel on lean NASH. He also goes on to note excitement for late breakers and learning about novel compounds and newly emerging Phase 3 results. In summary, Jörn describes EASL Congress as “the place where we really shape the future of NAFLD therapy.”

From here Louise highlights her interest in virtually viewing sessions on patients and advocacy and nurses and allied health. Aleksander notes an emphasis in this year’s agenda on having interactive, hands-on elements to participate with. For example, there will be educational opportunities to engage the community with learning how to administer FibroScan. Roger notes the EASL Studio as a capturing component to look out for this year. There will be two studios: one around new treatments, pathways and drug development, and the other dedicated to nomenclature. Roger goes on to describe his personal interest in discovering the latest directions of drug development and noninvasive testing. As the session winds down, Aleksander delivers a comprehensive and compelling list of important activities to be on the lookout for. Surf on to discover what they are.

If you enjoy the episode, have questions or interest around EASL Congress 2023 and Fatty Liver disease, 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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Surfing NASH offers an exciting preview of EASL Congress 2023 with new guest and EASL Vice-Secretary, Aleksander Krag, alongside EASL Educational Councillor, Sven Francque, and Surfers Jörn Schattenberg, Louise Campbell and Roger Green. The world’s largest liver meeting takes place 21-24 June in Vienna with an international faculty of experts from over 200 institutions. The diverse program will feature 2500 abstracts and be a uniquely momentous occasion for developing multidisciplinary approaches aimed at putting a major dent in Fatty Liver disease.

In this conversation, the audience is introduced to Aleksander and his work in Fatty Liver disease. He describes a career trajectory which began in gastroenterology before becoming enthralled with the variations and challenges associated with the liver. Aleksander goes on to recall a defining moment when he had an abstract accepted for EASL. “Suddenly I was there among equally minded people from all over the world. Wasn’t that just amazing?” Now fully integrated into the global liver family, Aleksander enjoys being a leader who drives inspiration into the next generation of hepatologists and collaborating with all stakeholders to create a future with better liver care. After serving two years as Vice-Secretary of the EASL Congress, Aleksander will become the Secretary General for the term of 2023-2025.

From here, the conversation observes a few particular elements of this year’s meeting that will make it a special one. Aleksander highlights that the meeting has “never been wider” with a diverse lineup of contributors and collaborators which expands engagement beyond abstracts and Phase 3 trial launches. Specifically, he describes outreach activities that deliver liver screenings to the streets and provide education to local schools on nutrition and the importance of liver health. Sven adds that there is something for everyone here, be it related to nurses, patients, industry or science. All in all, when compared to previous meetings both Sven and Aleksander instill a bubbling excitement that leaves the audience with high expectations.

Listen to the full feature for the most detailed preview of the event and follow along as the Surfers convene for live coverage. If you enjoy the episode, have questions or interest around EASL Congress 2023 and Fatty Liver disease, 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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Stephen Harrison joins Louise Campbell and Roger Green for an insight-laden episode about challenges and opportunities in NASH drug development. This final conversation unpacks a stimulating deep dive into the science and strategy behind quantitating and reducing hepatocellular ballooning. As for the closing question, Roger asks what will be the biggest difference to emerge in trial execution design over the next two years. Stephen begins his response with the suggestion that AI-assisted pathology could one day be a potential surrogate endpoint. Tune in to find out how and why.

If you enjoy the episode, have questions or interest around NASH therapeutic development, 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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