Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is a growing global concern.

Often linked to metabolic factors such as obesity, type 2 diabetes, and metabolic syndrome, MASLD can progress to metabolic dysfunction-associated steatohepatitis (MASH), previously referred to as non-alcoholic steatohepatitis (NASH). This severe form of the disease increases the risk of cirrhosis and liver cancer.

Prime HCD’s ‘The Global Assessment of the Impact of NASH (GAIN)’ study provides valuable insights into the clinical and sociodemographic factors driving NASH progression. By analysing real-world, physician-reported data from over 3,500 patients, the study highlights the determinants of fibrosis progression, a critical marker of disease severity. Let’s explore the key findings and their implications for clinicians, patients, and policymakers.

Key Findings from the GAIN Study & Implications for Clinical Practice

Clinical Factors

  1. Time Since Diagnosis: Each additional year since diagnosis raises the odds of progression.
    • This underscores the progressive nature of NASH and the importance of early intervention.
  2. Severity at Diagnosis: Patients diagnosed with advanced fibrosis stages or those recommended for liver transplantation at diagnosis had significantly higher progression rates.
  3. Comorbidities: Conditions like type 2 diabetes (T2DM) and hypertension significantly amplify the risk of progression.

Actionable Insight for Clinical Practice:

  • Proactive Monitoring: Early diagnosis and routine assessments of fibrosis progression are essential.

Lifestyle & Socioeconomic Factors

  1. Sex Differences: Men were more prone to fibrosis progression than women.
  2. Lifestyle Factors: Smoking and obesity significantly increased progression odds. These modifiable factors highlight the importance of lifestyle interventions in disease management.
  3. Employment Status: Patients who were retired, unemployed, or unable to work due to NASH faced significantly higher odds of progression compared to those in full-time employment. This finding emphasizes the broader socioeconomic impact of the disease.

Actionable Insight for Clinical Practice:

  • Personalized Care Plans: Recognizing the influence of sex, lifestyle, and socioeconomic status enables clinicians to tailor treatment plans. For example, male patients and smokers may benefit from more aggressive monitoring and interventions.
  • Lifestyle Interventions: Incorporating behavioural health support into care models is a key opportunity.

Empowering Patients with Knowledge & A Call to Action for Policymakers

Understanding the interplay of clinical and sociodemographic factors is crucial for empowering patients and shaping public health strategies.

  • For Patients: Understanding the drivers of NASH progression can be life changing. Simple lifestyle changes, such as quitting smoking and adopting healthier eating habits, can alter the disease trajectory. Early diagnosis and consistent follow-up with healthcare providers are critical.
  • For Policymakers: Raising awareness about modifiable risk factors through educational campaigns can empower patients to take proactive steps and improve health outcomes.

At Prime we thrive on providing actionable insights on global healthcare challenges, keenly aware that to impact outcomes for patients, solutions often have to be multifaceted.  

If you would like to speak with us about your healthcare challenge, please contact Lesley.piltz@primeglobalpeople.com