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
Early promise from #FMT in small studies for improving both liver disease and AUD and cravings; phages might also play a role, from proof-of-concept study #TLM22
Adding antibiotic regimen to steroids did not improve survival in ~240pt Antibiocor trial, presented last year - a growing number of other promising targets but none close to approval #TLM22
Ashwani Singal now discusses issues around selecting for patients with AUD and liver disease for LTx #TLM22
Singal highlights the QuickTrans study from the Lille group on early liver transplantation, which attempted a more objective LTx selection approach thelancet.com/journals/langa… #TLM22

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More from @LancetGastroHep

Nov 6
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
Nov 4
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
Read 11 tweets
Nov 4
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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