Progress in Fatty Liver and Pediatric Liver Disease


WASHINGTON, DC — Advances in the treatment of nonalcoholic steatohepatitis (NASH) — including results from a phase 2 trial of a liver-targeted selective inhibitor of acetyl-CoA carboxylase — will be in the spotlight here at The Liver Meeting 2017: American Association for the Study of Liver Diseases (AASLD).



Dr Anna Lok

“At this stage, the most exciting things are the fatty liver disease clinical trials,” said AASLD President Anna Lok, MD, from the University of Michigan in Ann Arbor.

The randomized, placebo-controlled phase 2 trial, which will be presented during a late-breaking session, examines the ability of GS-0976, an acetyl-CoA carboxylase inhibitor, to forestall elevated lipogenesis. The investigators will discuss the MRI proton-density fat fraction findings they used to assess efficacy in NASH patients.

“There are also a few trials on pediatric liver disease that are pretty exciting,” Dr Lok told Medscape Medical News. “They address rare liver diseases that may not always get a lot of attention, but they are breakthroughs because many of these diseases have not had many effective treatments for a long time.”

Pediatric Cases

One of these presentations will be findings from the late-breaking phase 2 IMAGINE study that evaluated the safety and efficacy of an apical sodium-dependent bile acid transporter inhibitor in the treatment of Alagille syndrome, a rare genetic disorder characterized by liver damage that involves bile duct abnormalities.

A third late-breaking trial will look at whether a biomarker could help clinicians identify which children with alpha-1 antitrypsin deficiency, a genetic liver disease, are at highest risk for portal hypertension. Although it is not a rare disorder, the clinical course it takes often varies and can be difficult to predict, Dr Lok explained.

“It seems like we’re making some headway on these pediatric liver diseases,” she said.

Hepatitis B, Gut Microbiome

In addition, hepatitis B trials “that are at a very early stage of development” will be featured at the meeting, Dr Lok reported. “They sound promising, but it’s so early that it’s really hard to know how they will do.”

One session, for example, examines the path toward a cure for hepatitis B infection.

“The meeting covers every liver disease,” the AASLD president added. “It is mostly driven by abstracts, so it can vary, but it’s not a hepatitis meeting or a liver cancer meeting. It covers everything.”

The relation between gut microbiota and the liver will be addressed during this year’s Hans Popper Basic Science State-of-the-Art Lecture. Bernd Schnabl, MD, from the UC San Diego School of Medicine, will explain what is known about gut microbiome changes and the development of liver disease, and will focus on the impact that an understanding of the gut microbiome could have on future therapeutic options for people living with liver disease.

New this year are a second session of late-breaking oral abstracts and a third debrief session.

“The meeting has grown so big that it’s impossible to go to all the sessions you may want to go to, so the debrief sessions are very important,” said Dr Lok. “These sessions help you catch the most important highlights from the whole meeting.”

In addition to reviewing prominent presentations on nonalcoholic fatty liver disease and hepatitis, the third debrief will encompass everything else.

These sessions help you catch the most important highlights from the whole meeting.

“The meeting is not just about learning what is new. For many of us who go year after year, it’s about reconnecting with your friends,” said Dr Lok. “You also get to know new people at every single meeting. And for people interested in doing research, as we all know, making connections and networking are very important. These are some of the reasons face-to-face meetings still occur.”

“The group is getting bigger, so we needed a big venue,” she added. “We’ll be in Washington, DC, so how can we not take advantage of one of the museums?”

The AASLD members reception — the largest social event of the meeting — will be held at the Smithsonian National Museum of Natural History.

Some of the presentations will be posted online after the meeting as part of the AASLD LiverLearning program, but not every aspect of the meeting will be covered. “So if you really want to know what is going on, what is exciting, and what is new, you have to go to the meeting,” said Dr Lok.

Dr Lok reports receiving research grants from Bristol-Myers Squibb and Gilead, but all funding goes to her institution.

Follow Medscape Gastroenterology on Twitter @MedscapeGastro and Damian McNamara @MedReporter



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