KOL Highlights Include:
Disclaimer: The physician interviewed is currently involved in active clinical trials and is under a confidentiality agreement. Only publicly available information regarding compounds in clinical development for NASH was discussed.
“The prevalence data would suggest that in the US population about 30% of our population has fatty liver or NAFLD and of those 25% may have NASH and of those patients with NASH 25% percent may have fibrosis and progress to cirrhosis. It’s almost a pyramid effect, there may be 80 million Americans walking around with NAFLD, but to climb up to the top of the pyramid and develop cirrhosis would be about 5% of that total population, but that’s still significant because that would mean that the prevalence of cirrhosis [due to NASH] will exceed that of hepatitis C-related cirrhosis ten-fold.” “You can have a 3 point decrease in their NAFLD score, because all the fat was there and then all the fat was gone but that person is at no higher risk of liver injury than before they ate all that McDonald’s. If you take someone however, that has NASH with bridging fibrosis and they had three points in fat and their fat goes away, they’re risk of complications of liver disease is no different irrespective of the improvement of fat. If you improve someone’s inflammatory score, ballooning stage, fibrosis stage, then you’re really getting at more tangible improvements in injury.” “Sure it’s a concern. People with fatty liver disease don’t die of their fatty liver disease, but they die of their myocardial infarctions. So, the implication of lipids, we don’t want to introduce something to treat fatty liver disease if we can potentially make something else worse. That’s where the field needs more data.” “So far what has been shown to be true in animals has been true in humans. Insulin resistance and diabetes are associated with worsening fibrosis in animal models and that has proven to be true in humans. We’ve learned that the Western fat diet is worse for animals that get fatty liver disease and they get worsening of liver injury and that has shown to be true in humans. So do I think an animal model can replicate human disease, yes I do.”
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