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The Lancet Gastroenterology & Hepatology Profile picture
@LancetGastroHep
Nov 4, 2022 • 11 tweets • 8 min read • Read on X
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In the #NAFLD #ALD SIG, @stefano_romeo76 begins with a discussion of mechanisms of disease #TLM22
Some classic genetic stories, and some more recent ones… #TLM22
@mandrekp now discusses the corresponding mechanisms for #ALD #TLM22
Samer Gawrieh now on interaction of #ALD and #NAFLD - HOMA-IR strongest risk for incr histological severity of ALD #TLM22
* in that analysis
@NoureddinMD now on the rapidly shifting landscape of noninvasive biomarkers for #NASH #NAFLD, complete with a health warning for the number of slides #TLM22
NIS4 and FAST scores for identifying at risk NASH, read the studies here: thelancet.com/journals/langa… thelancet.com/journals/langa… #TLM22
How to put it all together? Perhaps like this #TLM22
@MajaThiele now gives the #ALD noninvasive test perspective, beginning with a summary of biomarkers for severe fibrosis - good TE and ELF performance #TLM22
Optimal TE cutoffs vary markedly by study, perhaps due to spectrum bias and active inflammation - data from this 2018 IPD-MA thelancet.com/journals/langa… #TLM22
So what cutoff to use? Thiele suggests rule of five #TLM22

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More from @LancetGastroHep

The Lancet Gastroenterology & Hepatology Profile picture
Dec 21, 2023
A selection of highlights from @LancetGastroHep over the past 12 months - a mix of our most read, most discussed, and Editors' favourites 👉👉👉

#GITwitter #LiverTwitter Image
For patients with NASH-related cirrhosis, 48 weeks of semaglutide did not improve liver fibrosis or result in resolution of NASH



@DrLoomba @ArunJSanyalVCU @schattenbergJ @phil_newsome7 #LiverTwitterthelancet.com/journals/langa…
@DrLoomba @ArunJSanyalVCU @schattenbergJ @phil_newsome7 By contrast, the GALA-RIF trial suggested that rifaximin-α might reduce progression of liver fibrosis in alcohol-related liver disease



@IsraelsenMads @MajaThiele @AleksanderKrag @LiverGALAXY #LiverTwitterthelancet.com/journals/langa…
Read 12 tweets
The Lancet Gastroenterology & Hepatology Profile picture
Nov 6, 2022
Calvin Pan now presents on maternal TDF for prevention of vertical transmission in highly viraemic mothers #TLM22 clinicaltrials.gov/ct2/show/NCT03…
280 HBeAg+ mothers gestational age 12-13 weeks randomised 1:1 to early TDF from GW 14, or control group of TDF at GW 28. All infants got active immunoprophylaxis and HBIg only given to infants in the control group; 1ry endpoint HBV transmission at 28 weeks #TLM22
Women in experimental arm had lower HBV DNA at delivery; there was no transmission of HBV to infants in either group. A sensitivity analysis suggested a conservative 2% infection rate in experimental arm. Safety similar, but small numbers #TLM22
Read 4 tweets
The Lancet Gastroenterology & Hepatology Profile picture
Nov 4, 2022
In part 2 of the #ALD #NASH SIG, Stephen Harrison covers #NASH therapeutics and MoAs #TLM22
@juanpabloarab now covers the therapy landscape for alcohol-associated hepatitis - steroids suboptimal with benefits beyond 1 month limited #TLM22
In the US, lack of response indicates a huge unmet need - @juanpabloarab #TLM22
Read 7 tweets
The Lancet Gastroenterology & Hepatology Profile picture
Nov 4, 2022
Giving the Thomas Starzl transplant state of the art lecture this year is Peter Friend, on normothermic transplantation — the ice box is now the rate limiting step, especially for extended criteria organs #TLM22 @OxTxResearch
Published trials for benefits of normothermic perfusion devices accumulating, typically reduced acute liver injury, post-reperfusion syndrome, utilisation, and preservation time - but randomisation process in this setting introduces inherent selection biases #TLM22 ImageImageImage
Upcoming PLUS trial uses a prospective NMP arm and identical criteria retrospective control arm, given investigators unwilling to randomise higher risk of organs #TLM22 Image
Read 4 tweets

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