Non-Alcoholic Steatohepatitis Patient Characterization and Real-World Management Approaches in Italy.

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL
Pragmatic and Observational Research Pub Date : 2024-10-10 eCollection Date: 2024-01-01 DOI:10.2147/POR.S472468
Elisabetta Bugianesi, Luca Miele, Giovanna Donnarumma, Katrine Grau, Mariarosaria Mancuso, Preethy Prasad, Andrea Leith, Victoria Higgins
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引用次数: 0

Abstract

Background: Although the estimated prevalence of non-alcoholic steatohepatitis (NASH) in Italy is 4-6%, little is known about patient characteristics and care pathways.

Aim: To describe patient characteristics and management approaches for patients with NASH or suspected NASH in Italy.

Methods: Data were drawn from the Adelphi Real World NASH Disease Specific Programme™, a cross-sectional survey of endocrinologists and gastroenterologists in Italy from January to March 2018. Physicians completed questionnaires for their next five consecutively consulting patients with NASH or suspected NASH. Analyses were descriptive.

Results: Seventy-six physicians provided data on 380 patients. The mean age was 58.5 ± 11.1 years and the mean body mass index was 31.8 ± 5.5 kg/m2. A total of 231 patients (61%) had no/non-advanced fibrosis as evaluated by liver biopsy or non-invasive tests. Common diagnostic assessments were cholesterol, hemoglobin A1c, absence of viral hepatitis, and alcohol assessment. At diagnosis, 87% (n=322/372) and 45% (n=169/372) of patients received an ultrasound and liver biopsy, respectively. Overall, 88% of patients were referred from primary to secondary care. Obesity (81%) and type 2 diabetes (62%) were the most commonly recorded comorbidities, with 70% of patients having ≥3 comorbidities. Vitamin E (13%) and GLP-1 receptor agonists (13%) were the most prescribed guideline-recommended treatments for all patients.

Conclusion: Patients with NASH in Italy had high levels of obesity and comorbidities, while diagnosis and treatment frequently were not according to guidelines. Our data show an unmet need for more targeted diagnosis and treatment in Italian patients with NASH, in order to optimize outcomes.

意大利的非酒精性脂肪性肝炎患者特征和实际管理方法。
背景:目的:描述意大利非酒精性脂肪性肝炎(NASH)或疑似 NASH 患者的特征和管理方法:数据来自阿德尔菲真实世界 NASH 疾病专项计划™,这是 2018 年 1 月至 3 月对意大利内分泌科医生和消化科医生进行的横断面调查。医生们填写了他们连续咨询的下五位 NASH 或疑似 NASH 患者的调查问卷。分析为描述性分析:76名医生提供了380名患者的数据。平均年龄为 58.5 ± 11.1 岁,平均体重指数为 31.8 ± 5.5 kg/m2。共有 231 名患者(61%)通过肝活检或非侵入性测试评估为无/非晚期纤维化。常见的诊断评估包括胆固醇、血红蛋白 A1c、无病毒性肝炎和酒精评估。确诊时,分别有 87% (322/372 人)和 45% (169/372 人)的患者接受了超声波检查和肝活检。总体而言,88%的患者是从初级医疗机构转诊到二级医疗机构的。肥胖(81%)和2型糖尿病(62%)是最常见的合并症,70%的患者合并症≥3种。维生素E(13%)和GLP-1受体激动剂(13%)是所有患者最常接受的指南推荐治疗:结论:意大利的 NASH 患者肥胖和合并症水平较高,而诊断和治疗往往不符合指南要求。我们的数据表明,意大利的 NASH 患者对更有针对性的诊断和治疗的需求尚未得到满足,因此需要优化治疗效果。
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来源期刊
Pragmatic and Observational Research
Pragmatic and Observational Research MEDICINE, GENERAL & INTERNAL-
自引率
0.00%
发文量
11
期刊介绍: Pragmatic and Observational Research is an international, peer-reviewed, open-access journal that publishes data from studies designed to closely reflect medical interventions in real-world clinical practice, providing insights beyond classical randomized controlled trials (RCTs). While RCTs maximize internal validity for cause-and-effect relationships, they often represent only specific patient groups. This journal aims to complement such studies by providing data that better mirrors real-world patients and the usage of medicines, thus informing guidelines and enhancing the applicability of research findings across diverse patient populations encountered in everyday clinical practice.
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