Fatty liver disease (FLD) and nonalcoholic steatohepatitis (NASH) are increasing in prevalence worldwide, creating a major global public health crisis. To adequately educate patients, practitioners, and policymakers, there is a need to collect, curate and share relevant information. NASH News, published on behalf of the Global Liver Institute’s NASH Council, intends to meet that need and to facilitate collaboration across the emerging NASH community on a monthly basis.
We would appreciate your feedback and content contributions. Please contact nash@globalliver.org.
People living with serious and chronic illnesses benefit from eating foods that are healthful in relation to their diagnosis. While a liver patient’s journey may feel hectic or their daily schedules impacted by requirements for treatment regimens, there is one aspect that they can help manage — their food. Nutrition is one of the most important aspects a patient can learn to manage regarding their health. It is a vital aspect of their healthcare prescription but also empowers patients to be more in charge of their lifestyle.
It is important for patients that conversations around food as medicine are elevated. GLI recognizes how critical it is to achieve a healthcare system in which nutrition and food are a routine part of evidence-based disease prevention and treatment. To do this, GLI is working to develop practical and accessible methods that are both evidence-based and patient-driven to help people eat and live healthier. GLI has partnered with NutriStyle Inc. to create a personalized nutrition app for people who want to maintain good liver health or are living with liver disease, diabetes, and other chronic conditions. The app supports patients creating personalized meal plans to meet the specific requirements set out by GLI nutritional advisors for people with NASH or a general interest in liver health. This new partnership reflects the importance of nutrition in preventing and managing liver diseases and related conditions.
Additionally, GLI has partnered with the Food and Nutrition Innovation Council at Tufts University’s Friedman School of Nutrition Science & Policy to address nutrition concerns for better liver health. This collaboration empowers GLI to work with leading nutrition scientists, companies, investors, and advocacy to better understand and promote breakthroughs in nutrition science, health, technology, behavior change, and technology.
With these initiatives and more, GLI is working to ensure every liver patient has access to comprehensive and timely information and resources, culturally and socially appropriate support, and equitable systems of care that they deserve to live their lives to the fullest.
Donna R. Cryer, JD
President & CEO
Global Liver Institute
GLI News
Register Today to Attend the Virtual NASH Externally-Led Patient-Focused Drug Development (EL-PFDD) Meeting
GLI is excited to work with the liver advocacy community, including member organizations within GLI’s Liver Action Network (LAN), to lead the first NASH EL-PFDD to be held virtually on November 4, 2021. An EL-PFDD meeting of this magnitude will allow the U.S. Food and Drug Administration (FDA) and other stakeholders across the medical field to obtain a wide range of patients’ and caregivers’ input on NASH, including their perspectives on their condition, its impact on daily life, and the urgency around developing therapies. Register to attend.
NASH Congressional Briefing
Last month, the American Association for the Study of Liver Diseases (AASLD) and Global Liver Institute (GLI) led a virtual briefing focused on establishing a national strategy to advance the prevention, treatment, and diagnosis of NASH. Moderated by AASLD President Raymond T. Chung, MD, FAASLD and Donna Cryer, JD, CEO and Founder of GLI. Watch the recording.
Global Liver Institute Applauds Congresswoman Velázquez and Senator Duckworth for Bold Action on Liver Health
Global Liver Institute applauds the actions of U.S. Representative Nydia Velázquez (D-NY) and U.S. Senator Tammy Duckworth (D-IL) to improve the lives of all people impacted by liver disease with the introduction of the Liver Illness, Visibility, Education and Research Act (LIVER Act) in the U.S. House of Representatives and the U.S. Senate, as well as the Recognizing October 2021 as Liver Cancer Awareness Month Resolution in the House.
To reach out directly to your member of Congress and ask them to become a cosponsor of the LIVER Act, please click here.
GLI President and CEO Donna Cryer authors article for new Health Affairs Blog short series, “Value Assessment: Where Do We Go Post-COVID?”
Cryer’s article, The Future Of Value Assessment In A Post-Pandemic United States, focuses on how we think about value in health care going forward and how these ideas might translate into policy. “If we learn the right lessons from the COVID pandemic, the future of value assessment will be one that highly values people with—and without—serious, chronic conditions or disabilities as essential members of society.”
Bosses Wear Burgundy
Join Global Liver Institute in demonstrating your support for patients and families affected by liver disease around the world.
To honor the millions of people worldwide living with liver disease post a picture of yourself on social media, wearing a burgundy tie, shirt, or scarf, using #BossesWearBurgundy, and invite others to join you in demonstrating your support for patients and families affected by liver disease around the world.
Leadership in Liver Health Awards and Luncheon
On October 6, GLI held its inaugural Leadership in Liver Health Luncheon and honored Nicole Golden, DNP, FNP-BC, Veronica Roye, DNP, FNP-BC, and Monica Nelson-Kone, BSN, RN, the team behind the Black Liver Health Initiative at New York-Presbyterian, with the GLI Health Equity Award. Their team has done tremendous work in enhancing engagement with the Black community through building awareness, increasing access, and advancing transplant care. Thanks to our partners and sponsors, we raised crucial issues in liver health and showcased successes in improving the lives of those living with liver disease.
Julia Wattacheril, MD, MPH, Veronica Roye, DNP, FNP-BC, Nicole Golden, DNP, FNP-BC, Donna Cryer, JD, and Rev. Thomas L. Bowen.
GLI Live
GLI Live has returned! Join Global Liver Institute President and CEO, Donna Cryer in conversation with global experts in policy, research, clinical care, and wellness as they put liver patients and the challenges they face front and center. Join GLI Live with your questions on Facebook every Wednesday at 12 pm ET.
Upcoming GLI Events
November 4, 2021: NASH Externally-Led Patient-Focused Drug Development (EL-PFDD) Symposium. Register now
December 16, 2021: NASH Council Meeting. Contact NASH@globalliver.org
January 20, 2022: Beyond the Biopsy (en français). Contact NASH@globalliver.org
June 9, 2022: International NASH Day. Contact Livia Alimena for more information
Patient Perspective
Patient Advocacy – Navigating an Unfamiliar System
John M. is a patient and advocate for thousands of patients, who like him, have suffered from the burden of GI disease. His journey began at the age of 18 with a gallbladder attack, which ultimately led to a diagnosis of chronic pancreatitis. In 2013, he underwent a total pancreatectomy with auto-islet transplant. While the procedure saved his life, he understood the potential for liver complications to arise from being placed on total parenteral nutrition (TPN). Further complications and additional tests later revealed that John was suffering from NASH and the early stages of cirrhosis. “While I was well-versed in pancreatic and motility disorders, I shrugged this off as being ‘not a big deal’, not having known much about the liver at that point in time.”
After attending his first medical conference in 2017, John built relationships that helped him understand what he was going through and developed a newfound passion for advocacy and enrolled in GLI’s Advanced Advocacy Academy (A3). Since then, John has dedicated his time to raising awareness and advocating on behalf of patients like him. “If I’m only able to accomplish one goal as a patient advocate, it would be ensuring that the system is cognizant of the patient with no healthcare experience who is struggling to navigate an unfamiliar system.”
GLI Partner Highlight
Community Liver Alliance
GLI is pleased to welcome Community Liver Alliance as one of the newest members of the GLI NASH Council. Community Liver Alliance is dedicated to transforming the future of liver disease by sharing best practices and driving the implementation of knowledge. They unite patients, providers, and industry to deliver the best possible care and develop new, scalable solutions to the growing worldwide issue that is NASH.
Research & Development
Artificial Intelligence in Nonalcoholic Fatty Liver Disease: A New Frontier in Diagnosis and Treatment
The lack of efficient screening methods paired with showing no symptoms makes it difficult to properly identify patients with NAFLD. The rise of artificial intelligence (AI) in medicine may solve this problem by identifying patients with explicit and implicit risk factors for NAFLD as well as assessing the severity of NASH and advanced fibrosis. While there are few studies that have demonstrated its utility, there is a promising future for AI becoming increasingly relevant in the diagnosis and management of NAFLD and NASH.
Utility of Fibroscan XL to Assess the Severity of Non-Alcoholic Fatty Liver Disease in Patients Undergoing Bariatric Surgery
A recent study shows the Fibroscan with XL probe is a useful tool to assess NAFLD and NASH in bariatric surgery patients with obesity and can be performed reliably and safely both pre-and post-surgery. Fibroscan had previously been considered difficult to use in morbidly obese populations and produced unreliable results in up to 50% of patients, but the XL probe has demonstrated high success rates. Additionally, this study showed substantial improvements in reducing hepatic steatosis and fibrosis in patients who underwent bariatric surgery in conjunction with significant weight loss indicating the potential for reversing NAFLD. Read the study
GLI NASH Resources
GLI Nutrition App with NutriStyle
GLI and NutriStyle Inc. have partnered to create a personalized nutrition app for people living with liver disease, diabetes, and other chronic conditions or who want to maintain good liver health. The app will create personalized meal plans to meet the specific requirements set out by GLI nutritional advisors for people with NASH or a general interest in liver health. Visit NutriStyle to learn more.
NASH Core Curriculum: A Comprehensive Online Resource Center
GLI, in collaboration with Clinical Care Options, launched the CME course, NASH Core Curriculum: A Comprehensive Online Resource Center to improve clinician understanding of foundational concepts in NASH diagnosis, management, and emerging pharmacologic treatment strategies. Resources are developed primarily for clinicians, including advanced practice clinicians, in hepatology, gastroenterology, endocrinology, and primary care. The full curriculum includes CME/CE-certified video modules, ClinicalThought™ expert commentaries, and downloadable presentations and resources.
The most recent module shared online focuses on making the diagnosis of NASH and features Wing-Kin Syn, MBChB, PhD, FACP, FRCP, as the module presenter. NASH Core Curriculum is supported by educational grants from Gilead Sciences and Novo Nordisk.
Reaching At-Risk Patients Through COVID-19 Vaccination Sites
GLI launched a collaborative effort with Summit Clinical Research to promote NASH awareness in the context of liver health and COVID vaccination via partnerships through city vaccination sites and direct patient education. Providers will be giving people who have just received their COVID-19 vaccination our new resource, After Your COVID-19 Vaccination, Take the Next Step for Your Liver. Please contact NASH@globalliver.org if you would like to share this resource through a COVID-19 vaccination site.
U.S. NASH Action Plan: Recommendations for Medical Societies
GLI and the GLI NASH Council released the U.S. NASH Action Plan to comprehensively address NASH and its impact on patients and families, public health, and the economy. It includes a set of actionable recommendations for the full spectrum of groups involved in NASH prevention and treatment. This month, we’re highlighting some of the recommendations for patient advocacy organizations:
- Education: Participate in conferences and educational fora to articulate patient experiences and expectations in NASH.
- Diagnosis: Participate in and support research in non-invasive diagnostics and biomarker validation initiatives.
- Patient Management/Treatment: Engage in collaborations with medical societies, health systems, and payors on the development of patient-centered care pathways, integrated care delivery models, guidelines, and quality measures.
- Policy Effort/Legislation: Advocate for the establishment of a Federal strategy for preventing, diagnosing, and treating NASH through supporting the NASH Care Act (H.R. 8658).
Surfing the NASH Tsunami
Catch the latest episodes of Surfing the NASH Tsunami podcast, which regularly features guest appearances by GLI staff such as Donna Cryer, GLI President and CEO; Andrew Scott, GLI Director of Policy; Jeff McIntyre, NASH Program Director; and Livia Alimena, EU Office Director.
Clinical Care
FDA Grants Marketing Authorization to Siemens Healthineers ELF Test for NASH Prognostic Assessment
Despite the liver biopsy being the current standard for liver disease diagnosis, it often comes with complications and may miss advanced disease detection. The FDA has granted clearance to a blood test called the Enhanced Liver Fibrosis (ELF™) test that measures three bloodborne indicators of liver scarring to help diagnose mild-to-moderate liver fibrosis. The ELF test can help assess the likelihood of progression to cirrhosis in patients with advanced fibrosis due to NASH. Read about ELF
AGA releases NAFLD/NASH Clinical Care Pathway
The American Gastroenterological Association worked with other professional societies, including the American Diabetes Association, American Osteopathic Association, Endocrine Society, and the Obesity Society, to develop a NAFLD/NASH Clinical Care Pathway that the groups say will facilitate “value-based, efficient, and safe care that is consistent with evidence-based guidelines, and setting the stage for future studies to examine the outcomes of such pathways.”
Current Clinical Trials
Clinical trials are at the heart of all medical advances. The goal of clinical trials is to determine if a new test or treatment works and is safe as well as other aspects of care, such as improving the quality of life for people with NAFLD or NASH. Since there are currently no medications approved for the treatment of NAFLD or NASH, clinical trials offer hope for many people and an opportunity to help researchers find better treatments for others in the future.