Proactive Approaches May Mitigate QOL Impacts of MASH

Metabolic dysfunction-associated steatohepatitis (MASH) places a significant burden on the lives of patients, but a proactive approach to preventing disease progression may help curb its most severe impacts on quality of life, a new study suggests. The findings were reported in the journal JHEP Reports.¹

MASH is associated with a significant risk of cardiovascular, renal, and metabolic disorders (CVRM), the authors explained.

MASH is also associated with a significant increase in the risk of mortality and healthcare resource utilization (HCRU), when matched by age and Charlson Comorbidity Index to patients without MASH.² Patients at a high risk of more advanced fibrosis also bear a greater disease burden, the authors added.¹

“As such, approaches that limit progression of advanced fibrosis in MASH are key to optimize patient outcomes,” they wrote.

Compounding the problem, the investigators said the disease can go undiagnosed for long periods of time due to a lack of consensus about how to diagnose it. Even when it is diagnosed, treatment options are limited, they said.

The study aimed to determine the impact of CVRM comorbidities and different fibrosis stages on patients with MASH using a set of real-world clinical data. They drew from an Adelphi Real World cross-sectional survey of physicians and their patients with MASH. The patients were from Canada, France, Germany, and Italy and participated in the survey between January and June 2024. The survey involved both physician and patient perceptions as well as retrospective clinical data.

The investigators obtained data from 247 physicians related to 2,675 patients. About one-third of the patients (31.1%) also completed the voluntary questionnaire. The patients had a mean age of 55.5 years, and 60% were male, the authors said. Multiple comorbidities were common, with a mean number of comorbidities of 3.6 (SD, ±2.4). Hypertension (45.9%), dyslipidemia (42.8%), and obesity (37.5%) were the most common comorbidities, the authors said.

Patients with CVRM comorbidities had significantly lower mean quality of life scores, according to the EuroQol 5 Dimension-5 Level questionnaire (EQ-5D-5L). Those with early fibrosis and CVRM comorbidities (524 participants) had a mean EQ-5D-5L score of 0.85 (±0.16), compared to 0.81 (±0.18) among patients with advanced fibrosis and CVRM comorbidities (113 participants). Yet, patients with early fibrosis and no CVRM comorbidities (48 participants) had mean EQ-5D-5L scores of 0.90 (±0.12).

The investigators further found that patients with advanced fibrosis and CVRM comorbidities had greater impairment compared to those with early fibrosis and no CVRM comorbidities based on the Work Productivity and Advocacy Impairment questionnaire. Those with advanced fibrosis and comorbidities (35 participants) had a mean score of 29.7 (±26.5) compared to 16.1 (±21.3) among the 28 patients with early fibrosis and no comorbidities (P = .0271).

“This global, multi-centered, cross-sectional survey revealed significantly worse HRQoL, productivity, and increased healthcare resource utilization outcomes for patients with MASH with more advanced fibrosis compared with those with MASH with less advanced fibrosis,” they said.

Patients who had CVRM comorbidities experienced a further reduction in their quality of life, they added.

Given this, the authors concluded additional research is needed to better understand the mechanistic relationship between comorbidities, fibrosis, and patient outcomes. But they said their immediate findings indicate “a need for early interventions to prevent a reduction in quality of life and overall wellbeing.”

References

1. Marquardt J, Ota R, Sebastiani G, et al. Real-world quality of life and healthcare resource utilization in patients with metabolic dysfunction-associated steatohepatitis. JHEP Rep. Published online February 4, 2026. doi:10.1016/j.jhepr.2026.101766

2. Charlton M, Tonnu-Mihara I, Teng CC, et al. Evaluating the burden of illness of metabolic dysfunction-associated steatohepatitis in a large managed care population: The ETHEREAL Study. J Manag Care Spec Pharm. 2024;30(12):1414-1430. doi:10.18553/jmcp.2024.24106