With non-alcoholic fatty liver disease (NAFLD) now affecting 24 percent of adults worldwide, organizers of today’s Global Forum decided it’s time to address the challenges of NAFLD globally and begin collaborating on how to improve research, education and care for patients with NAFLD-related conditions.
“In a big context of a lot of activities around fatty liver disease throughout the world, the Society decided this is the time to bring experts from every scientific society from every continent to describe what they are seeing in their region for a number of different reasons. One is educating all of us about the burden of this disease in different regions of the world, including the differences and similarities. And then, to me the most important other piece is bringing in collaboration across the globe to deal with this global problem,” said Zobair M. Younossi, MD, MPH, FAASLD, who is chairing the session along with Miriam B. Vos, MD.
Dr. Younossi noted that speakers representing AASLD, EASL, APASL, ALEH and AFASLD would highlight their perspectives on the clinical and epidemiologic burden of NAFLD in the adult population from their regions during the session. Additionally, Dr. Vos will address NAFLD in children from a global perspective as well. The speakers will convene for a panel discussion to address audience questions.
“NAFLD is rapidly becoming a major cause of end stage liver disease, including indications for liver transplantation, a major driver of liver cancer, and having substantial contribution to complications of cirrhosis,” said Dr. Younossi. “These clinical outcomes of NAFLD are quite important, but NAFLD can also affect patient reported outcomes, like quality of life and work productivity. Furthermore, NAFLD has a tremendous economic impact, both from caring for the complications of advanced liver disease, as well as other indirect economic impacts of the disease to the society.”
Dr. Younossi noted that the primary concern for hepatologists is the form of NAFLD known as non-alcoholic steatohepatitis (NASH). NASH patients develop fibrosis, and the fibrosis predicts mortality in NAFLD.
“The rate of progression of liver disease is not uniform across the world. Although obesity is the main driver of the growing burden of NAFLD and NASH, other conditions can promote its more rapid progression. One of these common co-morbidities is type 2 diabetes. In the context of the epidemic of obesity and type 2 diabetes worldwide, this is a disease that is becoming globally more prominent, impacting clinical outcomes and patient reported outcomes and having tremendous economic burden everywhere,” he said.
With no current treatment options, aside from lifestyle modification, and only invasive liver biopsy to accurately confirm the diagnosis and determine the stage of liver disease, focusing attention on research and collaboration is incredibly important in the pathway to better help liver patients with NASH and other NAFLD types.
“I hope we can put together efforts to develop accurate noninvasive tests, whether they are special imaging techniques or blood tests that can give us a clue that we are dealing with the more progressive type of NAFLD,” said Dr. Younossi, who added that there is also a great deal of effort focused on different treatment regimens that can either halt the progression of this disease or reverse it.
While most are in relatively early stages of clinical trials, about four of these agents have gone into phase 3 clinical trials, he explained, adding that approval of a useful regimen is still likely years away.
However, regardless of the limited treatment options and non-invasive diagnostics, it is vitally important for clinicians and researchers to put their minds together and recognize that NAFLD is not just a disease of the Western world.
“This is a liver disease that can impact anywhere in the world. It’s a global issue. Really this is a platform to start academic and scientific collaboration across the globe. AASLD can lead and facilitate these efforts so that we do get to bottom of this problem and have some solutions or a potential effective approach to manage it in the near term,” he said.