A global action agenda for turning the tide on fatty liver disease

Abstract

Background & Aims: Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care. Approach & Results: We developed an aligned, prioritized action agenda for the global fatty liver disease community of practice. Following a Delphi methodology over two rounds a large panel (R1 n = 344, R2 n = 288) reviewed the action priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. Priorities were revised between rounds and in R2 panelists also ranked the priorities within six domains: epidemiology, treatment and care, models of care, education and awareness, patient and community perspectives, and leadership and public health policy. The consensus fatty liver disease action agenda encompasses 29 priorities. In R2 the mean percentage of ‘agree’ responses was 82.4%, with all individual priorities having at least a super-majority of agreement (> 66.7% ‘agree’). The highest ranked action priorities included collaboration between liver specialists and primary care doctors on early diagnosis, action to address the needs of people living with multiple morbidities, and the incorporation of fatty liver disease into relevant non-communicable disease strategies and guidance. Conclusions: This consensus driven multidisciplinary fatty liver disease action agenda developed by care providers, clinical researchers, and public health and policy experts provides a path to reducing fatty liver disease prevalence and improve health outcomes. To implement this agenda, concerted efforts will be needed at the global, regional, and national levels.

Prevalence of metabolic dysfunction‐associated steatotic liver disease in the Middle East and North Africa

“…This lack of awareness, combined with underutilisation of non‐invasive tests, may lead to overlooking of the high‐risk NAFLD/MASLD patients who should otherwise be linked to appropriate NAFLD/MASLD care. In fact, a series of recent consensus statements on NAFLD/MASLD suggest that this approach to raise awareness should not only focus on the medical curricula for healthcare professionals but also on patients and policymakers 28 …”

Estimating the economic impact of comorbidities in patients with MASH and defining high-cost burden in patients with noncirrhotic MASH

“…In line with other chronic conditions, including obesity and type 2 diabetes, [38,39] Allen et al [19] have called for a global MASLD and MASH investment framework to guide the development of country-specific targets, optimize resource allocation, and reduce disease prevalence. [17,40] A global consensus statement published in 2023 agreed to replace the terms NAFLD and NASH with MASLD and MASH, respectively, to reflect the increased understanding of the metabolic etiology of MASLD as well as to remove potentially stigmatizing language. [1] This change in nomenclature was also accompanied by a change in definitions, with MASLD defined as the presence of at least 1 cardiometabolic risk factor relating to weight, glycemic dysregulation, blood pressure, or lipid dysregulation, in addition to steatosis.…”

“…Moreover, broader collaborative action at national and international levels may be warranted to drive substantive economic benefits. In line with other chronic conditions, including obesity and type 2 diabetes, 38,39 Allen et al 19 have called for a global MASLD and MASH investment framework to guide the development of country-specific targets, optimize resource allocation, and reduce disease prevalence 17,40 …”

“…In line with other chronic conditions, including obesity and type 2 diabetes, 38 39 Allen et al 19 have called for a global MASLD and MASH investment framework to guide the development of country-specific targets, optimize resource allocation, and reduce disease prevalence. 17 40 …”

Interleukin-13 (IL-13)—A Pleiotropic Cytokine Involved in Wound Healing and Fibrosis

“…Liver transplantation is limited by the small number of available donor organs, the risk of surgical is limited by the small number of available donor organs, the risk of surgical intervention, and the risk of immune rejection post-transplantation. Consequently, the development of alternative strategies for anti-fibrotic and anti-inflammatory liver regeneration is urgently needed with a view to clinical application [13,14].…”