M-A | Percutaneous catheter drainage superior to needle aspiration for liver abscess treatment success9 Aug, 2023 | 15:12h | UTC
Clinical Trial Update | Long-term Givosiran treatment shows sustained acute hepatic porphyria symptom improvement8 Aug, 2023 | 13:05h | UTC
Review | Diagnosis and management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome4 Aug, 2023 | 11:50h | UTC
Updated S2k Clinical Practice Guideline on Non-alcoholic Fatty Liver Disease (NAFLD) issued by the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS) – Zeitschrift für Gastroenterologie
Quality standards for the management of non-alcoholic fatty liver disease (NAFLD): consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology NAFLD Special Interest Group – The Lancet Gastroenterology & Hepatology (free registration required)
Bictegravir, emtricitabine, and tenofovir alafenamide versus dolutegravir, emtricitabine, and tenofovir disoproxil fumarate for initial treatment of HIV-1 and hepatitis B coinfection (ALLIANCE): a double-blind, multicentre, randomised controlled, phase 3 non-inferiority trial – The Lancet HIV (free registration required)
Systematic Review | Dual therapy of Rifaximin and lactulose potentially reduces risk in hepatic encephalopathy24 Jul, 2023 | 12:57h | UTC
RCT | Midodrine show promise as an alternative to albumin for the prevention of circulatory disturbance in paracentesis between 3 and 5 L18 Jul, 2023 | 13:47h | UTC
Midodrine versus Albumin to Prevent Paracentesis Induced Circulatory Dysfunction in Acute on Chronic Liver Failure Patients in the Outpatient Clinic–a Randomized Controlled Trial – Journal of Clinical and Experimental Hepatology
AHA Statement | Indications, evaluation, and outcomes for dual heart-kidney and heart-liver transplantation14 Jul, 2023 | 12:51h | UTC
AASLD Guidance | Use of TIPS, variceal embolization, and retrograde transvenous obliteration in variceal hemorrhage11 Jul, 2023 | 13:59h | UTC
Commentary on Twitter
Big news in the field of Hepatology
In 1980, Jurgen Ludwig and his colleagues at Mayo Clinic, identified a severe type of fatty liver disease in people who did not drink signficant amounts of alcohol. The disease was more common in women, most patients were obese and suffered… pic.twitter.com/aAq2vneIov
— TheLiverDoc (@theliverdr) June 25, 2023
Summary: In a phase 2b, multicenter, double-blind, randomized, placebo-controlled trial, the fibroblast growth factor 21 (FGF21) analogue pegozafermin was examined for its efficacy and safety in treating patients with biopsy-confirmed noncirrhotic nonalcoholic steatohepatitis (NASH). A total of 222 patients with moderate or severe fibrosis (stage F2 or F3) were assigned to receive either subcutaneous pegozafermin at varying doses or a placebo. The primary endpoints were an improvement in fibrosis and resolution of NASH without worsening of fibrosis at 24 weeks.
The results showed that a larger percentage of patients receiving pegozafermin met the criteria for fibrosis improvement and NASH resolution compared to those receiving placebo. The most significant improvements were observed in the 44-mg pegozafermin group, with 27% showing fibrosis improvement and 26% meeting NASH resolution criteria, compared to 7% and 2% in the placebo group, respectively. Adverse events were mainly gastrointestinal and included nausea and diarrhea. These findings support the progression of pegozafermin into phase 3 development.
Article: Randomized, Controlled Trial of the FGF21 Analogue Pegozafermin in NASH – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Late breaking at #EASLCongress: In this phase 2b, placebo-controlled trial involving patients with nonalcoholic steatohepatitis, pegozafermin, a long-acting glycopegylated FGF21 analogue, reduced fibrosis at 24 weeks. Full results by @drloomba et al.: https://t.co/mfRRrV2yX2
— NEJM (@NEJM) June 24, 2023
Summary: This randomized phase 3 trial evaluated the efficacy of bulevirtide, an inhibitor of HDV entry into hepatocytes, in patients with chronic hepatitis D. Patients were randomized to receive either 2 mg or 10 mg of bulevirtide daily for 144 weeks, or no treatment for 48 weeks followed by 10 mg bulevirtide daily for 96 weeks. The study involved 150 patients, 49 in the 2-mg group, 50 in the 10-mg group, and 51 in the control group.
After 48 weeks of treatment, 45% and 48% of patients in the 2-mg and 10-mg groups respectively achieved the primary end point of undetectable HDV RNA level or a decrease of at least 2 log10 IU per milliliter from baseline, and normalization of ALT level. Only 2% in the control group reached the primary endpoint. ALT levels normalized in 51% and 56% of patients in the 2-mg and 10-mg groups respectively, a significant difference from the 12% normalization in the control group. Notably, loss of HBsAg did not occur by week 48 in the bulevirtide groups. No serious adverse events related to the treatment were reported, though side effects including headache, pruritus, and fatigue were more common in the bulevirtide groups.
These results demonstrate the effectiveness of bulevirtide in reducing HDV RNA and ALT levels in patients with chronic hepatitis D. However, the absence of HBsAg loss in bulevirtide groups raises questions about its long-term implications.
Article: A Phase 3, Randomized Trial of Bulevirtide in Chronic Hepatitis D – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Presented today at #EASLCongress: In a randomized trial, 48 weeks of treatment with bulevirtide, which inhibits hepatitis D virus entry into hepatocytes, reduced HDV RNA and alanine aminotransferase levels in patients with chronic hepatitis D. https://t.co/Q8RNZFbQlQ
— NEJM (@NEJM) June 22, 2023
Commentary on Twitter
📢NEW@EASLnews Clinical Practice Guidelines on acute-on-chronic liver failure
— Journal of Hepatology (@JHepatology) June 24, 2023
Performance of non-invasive tests and histology for the prediction of clinical outcomes in patients with non-alcoholic fatty liver disease: an individual participant data meta-analysis – The Lancet Gastroenterology & Hepatology
M-A | Significant non-alcoholic fatty liver disease prevalence in South Asia, many non-obese affected6 Jun, 2023 | 14:00h | UTC
AASLD-IDSA Guideline | Updated 2023 recommendations for the testing, management, and treatment of Hepatitis C virus infection1 Jun, 2023 | 12:21h | UTC