FibroMAX™: towards a new universal biomarker of liver disease?

Abstract

Among the noninvasive alternatives to liver biopsy, several studies have demonstrated the predictive value and a better benefit-to-risk ratio than biopsy of five combinations of simple serum biochemical markers (the super combination being FibroMAX (BioPredictive, Paris, France) in patients at risk of chronic liver diseases: FibroTest (BioPredictive) for the quantitative assessment of fibrosis; SteatoTest (BioPredictive) for the quantitative assessment of steatosis; ActiTest (BioPredictive) for the quantitative assessment of necroinflammatory activity in chronic viral hepatitis C and B; NashTest (BioPredictive) for the categorical diagnosis of nonalcoholic steatohepatitis; and AshTest for the quantitative assessment of alcoholic steatohepatitis (also known in the USA as HCV-FibroSURE, HBV-FibroSURE, ASH-FibroSURE and NASH-FibroSURE; LabCorp, NC, USA). The possible causes of false-negative and false-positive results are also better identified. These tests, which are now available in 50 countries, can facilitate the screening and management of the most frequent liver diseases.

Impact of Antiviral Therapy for Chronic Hepatitis C on Cytokine Synthesis and Hepatic Fibrosing Processes

“…По данным Т. В. Анто-новой и соавт., у больных ХГС при нормальной актив-ности трансаминаз выявлены корреляционные взаимосвязи между индексом гистологической актив-ности и содержанием ФНО-α, тогда как в случаях с выраженным синдромом цитолиза эти связи отсут-ствуют [7]. Тем не менее трансаминазы остаются мар-керами воспаления и фиброза печени, входя в биохи-мические гепатопанели, в том числе в ФиброМакс [23]. Нами выявлены значимые прямые корреляции концентрации ФНО-α и ИЛ-6 с маркерами цитолиза, ВН, ГК и индексом эластичности печени.…”

Non-invasive diagnostic assessment tools for the detection of liver fibrosis in patients with suspected alcohol-related liver disease: a systematic review and economic evaluation

“…66 The individual values are then entered into BioPredictive's website (www.biopredictive.com) and an algorithm calculates the results, which are presented as numeric estimates on a continuous scale ranging from 0.00 to 1.00. Table 8 displays the correspondence proposed by Morra et al 67 between FibroTest scores and the fibrosis stages identified by the METAVIR, Knodell, and Ishak fibrosis staging systems. FibroMAX combines the components of FibroTest with alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglycerides, fasting blood glucose, height and weight, and presents on one sheet the scores for FibroTest, SteatoTest (which measures hepatic steatosis) and AshTest (which measures the degree of necroinflammatory activity of alcoholic origin).…”

“…67 stated that the cost of FibroTest ranged from €90 to €300 and that of FibroMAX from €150 to €500. However, it seems likely that FibroTest will in the future be priced more competitively in relation to the ELF test.…”

“…To retrieve evidence of the diagnostic test reliability and accuracy, the broad and specific intervention terms (1-5, 9-15, 20-60) were combined with those of the clinical condition, namely liver fibrosis (6)(7)(17)(18)(19), and then combined with the diagnostic filter (62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74). Search terms for the diagnostic test manufacturers were also included in the strategy (75)(76)(77)(78).…”

“…69 Although FibroTest may be performed on blood samples from fasting or non-fasting patients, FibroMAX must be performed on samples from fasting patients. 67 As in the case of the ELF test, alcohol affects many of the variables used in FibroTest; therefore, individuals should ideally be abstinent before the blood sample is taken (Dr Marsha Morgan, Royal Free Hospital, London, 2010, personal communication).…”