Real-World Burden of Nonalcoholic Steatohepatitis

Geier, Andreas; Rinella, Mary E.; Balp, Maria‐Magdalena; McKenna, Sarah Jane; Brass, Clifford A.; Przybysz, Raymond; Cai, Jennifer; Knight, Amanda J.; Gavaghan, M.; Howe, T; Rosen, Daniel; Ratziu, Vlad

doi:10.1016/j.cgh.2020.06.064

Cited by 31 publications

(55 citation statements)

References 23 publications

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“…On the other hand, Golabi et al reported that HRQoL scores were the lowest for HCV patients, followed by NAFLD patients. These differences may be attributed to the use of different HRQoL scoring indices (domain scores of the 29-item Chronic Liver Disease Questionnaire (CLDQ) in Dan’s study versus the NHANES HRQOL-4 questionnaire in Golabi’s study) [ 23 , 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

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Quality of Life in Adults with Metabolic Dysfunction-Associated Fatty Liver Disease

Hwang

Han

2021

IJERPH

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The aims of this study were as follows: to investigate the association between metabolic dysfunction-associated fatty liver disease (MAFLD) and health-related quality of life (HRQoL), to evaluate whether stress perception and mental health among patients with MAFLD affect HRQoL, and to identify the underrated burden on MAFLD patients. Nationwide data from the 5th Korean National Health and Nutrition Examination Survey (KNHANES V, 2010 to 2012) were used. MAFLD was defined by a fatty liver index (FLI) of ≥60, and the EuroQol-5D (EQ-5D) was used to assess HRQoL. Logistic regression analysis and odds ratios (ORs) were used to determine the associations of MAFLD with stress, mental health, and HRQoL. Previous suicidal impulse was not found to be significantly associated with HRQoL. The risk of MAFLD increased 1.265-fold with an increase in stress levels based on the stress perception rate (confidence index (CI): 1.046–1.530; p < 0.05), while it increased 1.091-fold with a 1-point decrease in the EQ-5D score (CI: 1.019–1.169; p < 0.05). HRQoL impairment and stress levels are associated with MAFLD. It is important to evaluate stress levels among MAFLD patients and implement stress management and HRQoL improvement strategies.

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Section: Discussionmentioning

confidence: 99%

“…However, studies on the quality of life and stresses of patients with MAFLD are still lacking, since most studies on MAFLD have focused on its pathophysiology and management. Further, existing studies on correlation with quality of life used the traditional NAFLD criteria [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Quality of Life in Adults with Metabolic Dysfunction-Associated Fatty Liver Disease

Hwang

Han

2021

IJERPH

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“…All five studies scored highly in all or most relevant quality assessment categories (see section 3.4 for further details). Studies indicate a high demand for pharmacological and non-pharmacological interventions, as well as diagnosis and monitoring tests (Table 3) [22,27,29,30]. Use of tests and procedures varied depending on disease severity, as shown by one multinational study that showed increased utilisation of non-invasive tests and procedures in patients with more advanced fibrosis (stage 4 [F4]) [29].…”

Section: Healthcare Resource Utilisationmentioning

confidence: 99%

The Economic Burden of Non-Alcoholic Steatohepatitis: A Systematic Review

Witkowski¹,

Moreno

Fernandes

et al. 2022

PharmacoEconomics

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BackgroundThe global prevalence of non-alcoholic steatohepatitis (NASH) is increasing, such that NASH is predicted to become the leading cause of liver transplantation (LT) in the US by 2025. Despite this, data on the economic burden of NASH are limited. Objectives This systematic literature review aimed to summarise and critically evaluate studies reporting on the economic burden of NASH and identify evidence gaps for subsequent research. Methods Medline, EMBASE, the Cochrane Library and EconLit were searched up to 6 January 2021 for English language articles published from January 2010 to January 2021 inclusive that reported economic outcomes of a NASH population or subpopulation. Evidence was presented and synthesised using narrative data analysis, and quality was assessed by two reviewers using an 11-item checklist developed for economic evaluations and adapted to cost of illness. Results Fourteen studies were included, of which five presented data on costs and resource use, four on costs only and five on resource use only. Overall, NASH is associated with a significant and increasing economic burden in terms of healthcare resource utilisation (HCRU) and direct and indirect costs. This burden was higher among NASH patients with advanced (fibrosis stage 3-4) versus early (fibrosis stage 0-2) disease, symptomatic versus asymptomatic disease and for patients with complications or comorbidities versus those without. In LT patients, those with NASH as the primary indication had greater HCRU and higher costs compared with non-NASH indications such as hepatitis B and C viruses. Considerable variability in HCRU and costs was seen across the US and Europe, with the highest costs seen in the US. The quality of the included studies was variable, and the studies themselves were heterogeneous in terms of study methodology, patient populations, comorbidities, follow-up time and outcomes measured. Conclusions This review highlights a general scarcity of NASH-specific economic outcomes data. Despite this, the identified studies show that NASH is associated with a significant economic burden in terms of increased HCRU, and high direct medical and non-medical costs and societal burden that increases with disease severity or when patients have complications or comorbidity. More national-level NASH prevalence data are needed to generate accurate forecasts of HCRU and costs in the coming decades.

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“… 11 Other symptoms include abdominal bloating/swelling, abdominal discomfort, sleep disturbance, or apnea. 12 There are no data on difference in presentations amongst various ethnicities.…”

Section: Diagnosis and Manifestationsmentioning

confidence: 99%

Diversity in NAFLD: A Review of Manifestations of Nonalcoholic Fatty Liver Disease in Different Ethnicities Globally

Han

Tafesh

et al. 2020

Journal of Clinical and Translational Hepatology

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Globally, the rise in prevalence of obesity and metabolic syndrome as a whole has been linked to increased access to processed foods, such as refined sugars and saturated fats. Consequently, nonalcoholic fatty liver disease (NAFLD) is on the rise in both developed and developing nations. However, much is still unknown on the NAFLD phenotype with regards to the effect of ethnic diversity. Despite similarities in dietary habits, it appears that certain ethnicities are more protected against NAFLD than others. However, manifestations of the same genetic polymorphisms in different groups of people increase those individuals’ predisposition to NAFLD. Diets from different regions have been associated with a lower prevalence of NAFLD and have even been linked to regression of hepatic steatosis. Socioeconomic variations amongst different regions of the world also contribute to NAFLD prevalence and associated complications. Thus, a thorough understanding of ethnic variability in NAFLD is essential to tailoring treatment recommendations to patients of different backgrounds.

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Real-World Burden of Nonalcoholic Steatohepatitis

Cited by 31 publications

References 23 publications

Quality of Life in Adults with Metabolic Dysfunction-Associated Fatty Liver Disease

Quality of Life in Adults with Metabolic Dysfunction-Associated Fatty Liver Disease

The Economic Burden of Non-Alcoholic Steatohepatitis: A Systematic Review

Diversity in NAFLD: A Review of Manifestations of Nonalcoholic Fatty Liver Disease in Different Ethnicities Globally

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