Abstract
Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are common conditions with a rising burden. Yet there are significant management gaps between clinical guidelines and practice in patients with NAFLD and NASH. Further, there is no single global guiding strategy for the management of NAFLD and NASH. The American Gastroenterological Association, in collaboration with 7 professional associations, convened an international conference comprising 32 experts in gastroenterology, hepatology, endocrinology, and primary care providers from the United States, Europe, Asia, and Australia. Conference content was informed by the results of a national NASH Needs Assessment Survey. The participants reviewed and discussed published literature on global burden, screening, risk stratification, diagnosis, and management of individuals with NAFLD, including those with NASH. Participants identified promising approaches for clinical practice and prepared a comprehensive, unified strategy for primary care providers and relevant specialists encompassing the full spectrum of NAFLD/NASH care. They also identified specific high-yield targets for clinical research and called for a unified, international public health response to NAFLD and NASH.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1401-1412 |
| Number of pages | 12 |
| Journal | Obesity |
| Volume | 29 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2021 |
Funding
This article is based on a conference sponsored by the American Gastroenterological Association (AGA), with the financial support of independent medical education grants from Intercept Pharmaceuticals, Inc, Pfizer Inc, Allergan, and GENFIT and the support of the following collaborating medical associations: American Association of Clinical Endocrinologists, American Academy of Family Physicians, American Association for the Study of Liver Diseases, American College of Osteopathic Family Physicians, American Diabetes Association, Endocrine Society, and The Obesity Society. The authors are grateful for the contributions of the participants in the July 2020 conference, who are listed, together with affiliations, in the online Supporting Information . In addition, the authors acknowledge Dr. Anya Karavanov for her assistance with the NASH Needs Assessment Survey; Dr. Terra Ziporyn, medical editor, for her assistance with the manuscript; and Alissa Effland for her assistance with the manuscript’s graphics. These authors disclose the following: Jay H. Shubrook has served as an advisor to Sanofi, Eli Lilly, Novo Nordisk, Bayer, and MannKind. Elisabetta Bugianesi has served as a consultant to Gilead, BMS, Boehringer, Intercept, and Innova. Zobair Younossi has received research funding from or served as a consultant for Gilead Sciences, Intercept, BMS, Novo Nordisk, Viking, Terns, Siemens, Shionogi, AbbVie, Madrigal, Merck, Abbott, Axcella, and Novartis. Yamini Natarajan has received grants from Gilead and Allergan. Mary E. Rinella has served as a consultant for Amgen, Alnylam, Allergan, BMS, Boehringer Ingelheim, Coherus, CymaBay, Enanta, Fibrogen, Fractyl, Galecto, Gelesis, Genentech, GENFIT, Gilead, Intercept, Lipocine, Madrigal, Merck, Metacrine, NGM Biopharmaceuticals, Novo Nordisk, Novartis, Pfizer, Sagimet, Siemens, Takeda, Terns, Thetis, Viking, 3vBio, and 89Bio. Robert H. Eckel has served on advisory boards for Novo Nordisk, Provention Bio, Kaleido, and KOWA and a scientific advisory committee for PROMINENT (CVOT). Stephen A. Harrison has served as advisory board/consultant for Akero, Altimmune, Arrowhead, Axcella, B. Riley, Boston Pharma, Cirius, Civi Biotherma, CLDF, Corcept, CymaBay, Echosens, Fibronostics, Foresite Labs, Fortress, Galectin, Gelesis, GENFIT, Gilead, Hepion, Hightide Bio, HistoIndex, Intercept, Inipharm, Ionis, Kowa, Madrigal, Medpace, Metacrine, Microba, NGM Bio, NorthSea, Novartis, Novo Nordisk, Piper Sandler, Poxel, Prometic, Ridgeline Therapeutics, Sagiment, Sonic Incytes, Terns, Theratech, Viking, 89 Bio; received grant/research support from Axcella, BMS, Cirius, Civi Biopharma, Conatus, CymaBay, Enyo, Galectin, Galmed, Genentech, GENFIT, Gilead, Hepion, Hightide Bio, Immuron, Intercept, Madrigal, NGM Bio, NorthSea, Novartis, Novo Nordisk, Pfizer, Sagimet, Second Genome, Tobira/Allergan, and Viking; and has stock/shares (self‐managed) in Akero, Cirius, Galectin, GENFIT, Hepion, HistoIndex, Metacrine, NGM Bio, and NorthSea. Christos Mantzoros reports grants, personal fees, and other from Coherus Biosciences, grants, personal fees, and other from Novo Nordisk, personal fees and nonfinancial support from Ansh, Aegerion, PES, and California Walnut Commission, and personal fees from GENFIT, Intercept, Regeneron, CardioMetabolic Health Conference and The Metabolic Institute of America, and Amgen. Samuel Klein is a shareholder of Aspire Bariatrics and has served as a consultant for Pfizer, Novo Nordisk, and Boehringer Ingelheim. Robert H. Eckel has received research funding from Gilead (2014–2015), Merck (2016–2018), and Wako (2014–2017). Kenneth Cusi has received research support as principal investigator for the University of Florida from Cirius, Echosens, Inventiva, Novartis, Novo Nordisk, Poxel, and Zydus and is a consultant for Allergan, Astra‐Zeneca, Axcella, BMS, Boehringer Ingelheim, Coherus, Eli Lilly, Genentech, Gilead, HighTide, Inventiva, Intercept, Ionis, Janssen, Pfizer, Poxel, Prosciento, Madrigal, Novo Nordisk, and Sanofi‐Aventis. The remaining authors disclose no conflicts. This article is based on a conference sponsored by the American Gastroenterological Association (AGA), with the financial support of independent medical education grants from Intercept Pharmaceuticals, Inc, Pfizer Inc, Allergan, and GENFIT and the support of the following collaborating medical associations: American Association of Clinical Endocrinologists, American Academy of Family Physicians, American Association for the Study of Liver Diseases, American College of Osteopathic Family Physicians, American Diabetes Association, Endocrine Society, and The Obesity Society. The authors are grateful for the contributions of the participants in the July 2020 conference, who are listed, together with affiliations, in the online Supporting Information. In addition, the authors acknowledge Dr. Anya Karavanov for her assistance with the NASH Needs Assessment Survey; Dr. Terra Ziporyn, medical editor, for her assistance with the manuscript; and Alissa Effland for her assistance with the manuscript?s graphics.
ASJC Scopus subject areas
- Endocrinology
- Nutrition and Dietetics
- Medicine (miscellaneous)
- Endocrinology, Diabetes and Metabolism
