This study confirms the existence of a "window of opportunity" in early RA, when intensive combination therapy produces sustained benefits on damage and disability. Although methotrexate-prednisolone combinations reduce erosive damage, the synergistic effect of two DMARDs is needed to improve quality of life.

Liver allocation based on MELD-Na score successfully improved waitlist outcomes and provided significant benefit to hyponatremic patients. Given the discrepancy in transplantation survival benefit, the current rules for liver allocation might require revision.

This article has an accompanying continuing medical education activity, also eligible for MOC credit, on page e161. Learning Objective-Upon completion of this activity, successful learners will be able to learn recent outcome trends of liver transplantation, focusing on comparisons among major liver disease etiologies, including nonalcoholic steatohepatitis, hepatitis C cirrhosis, and alcoholic-related liver disease; and learn the importance of pre-transplant assessments and risk factors for poor post-transplant outcomes in patients with nonalcoholic steatohepatitis. BACKGROUND & AIMS: An increasing number of patients with non-alcoholic steatohepatitis (NASH) require liver transplantation. We compared outcomes of patients with liver diseases of different etiologies (NASH, hepatitis C virus [HCV]-associated liver disease, and alcohol-associated liver disease [ALD]). METHODS: We analyzed data from the United Network for Organ Sharing registry on 6344 patients who underwent liver transplantation for NASH, 17,037 for cirrhosis from chronic HCV infection, and 9279 for ALD. We collected data from patients who underwent liver transplantation during the following time periods:

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Services Final Rule stated that patients on organ transplant waitlists should be ranked by "medical urgency."1 The Model for End-Stage Liver Disease (MELD) score-based liver allocation was introduced in the United States in 2002.2-4 A major change was introduced to the liver allocation system, in 2016, with adoption of the MELD-Na score in response to the findings in a study by Kim et al.5 The study found that incorporation of serum sodium into the MELD formula allowed better discrimination of waitlist mortality than the MELD score. Allocation rules for higher-score patients have been modified with "Share 35," but the share rule for lower score patients has remained unchanged for over a decade. In 2005, Merion et al6 demonstrated