Chronic liver disease is on the rise and the burden is expected to increase in the future, both in the United States and around the world. These are the most-read articles about liver disease in 2021.
Nonalcoholic fatty liver disease (NAFLD) is a largely asymptomatic, silent disease and the incidence is rising. About 37% of US adults and as many as 70% of individuals with type 2 diabetes have NAFLD. Nonalcoholic steatohepatitis (NASH) is a subtype of NAFLD and is marked by inflammation and ballooning; left untreated, it can lead to hepatic fibrosis, cirrhosis, and hepatocellular cancer (HCC).
This is a collection of our most-read liver disease articles exploring this complex topic in 2021.
5. Approaching NAFLD Management With a Multidisciplinary Clinic Model
The complexity of NALFD, associated with metabolic disease, cardiac and diabetic complications, and lifestyle factors, makes it ideal for a multidisciplinary care model, according to a study published in Hepatology. Multidisciplinary care can help prevent progression, which is key as NAFLD becomes more prevalent, noted researchers. reviewed current models of multidisciplinary care teams and introduced a framework to build a comprehensive NAFLD program at Weill Cornell Medicine in New York.
4. Tremelimumab Added to Durvalumab Shows Positive Results in HCC
Results presented in October showed positive early results from the HIMALAYA phase 3 trial that adding the biologic tremelimumab added to durvalumab demonstrated a statistically significant and clinically meaningful overall survival benefit vs sorafenib as a first-line treatment for patients with unresectable HCC. The combination demonstrated a favorable safety profile, and the addition of tremelimumab to durvalumab did not increase severe hepatic toxicity. Patients had not received prior systemic therapy and were not eligible for localized treatment.
3. Poorly Differentiated Tumor Size Linked to Worse Prognosis in HCC, Study Finds
Tumor size is a significant prognostic indicator for survival in HCC, and the researchers said their results can help providers tailor treatment strategies. Published in the journal Liver Cancer in August, the study examined whether the prognostic effect of tumor differentiation on survival outcomes is modified by tumor size. Poorly differentiated HCC appears disorganized and has a tendency to spread aggressively; the researchers said a key finding is that ≥ 5-cm–sized tumors have a 2.33-fold risk of early extrahepatic recurrence.
2. Coffee Consumption Associated With Less Liver Stiffness
Coffee is associated with less liver stiffness, but not steatosis, and may be beneficial for people with or at risk for liver disease, according to a study published in Clinical Gastroenterology and Hepatology in October. The findings came from a sample of individuals from the National Health and Nutrition Examination Survey; the greatest benefit was seen in those who drank more than 3 cups per day.
1. Clinical Care Pathway Released for NAFLD, NASH
This fall, a new clinical care pathway was released for providers, including primary care, endocrinologists, obesity medicine specialists, and gastroenterologists to use when managing patients with NAFLD and NASH. The pathway outlines a 4-step screening process in order identify patients earlier to prevent disease progression and encourage value-based care. The pathway also stratifies patients by low and high risk.