Hepatology International最新文献

{"title":"Effects of dapagliflozin on liver steatosis in patients with nonalcoholic fatty liver disease: a randomized controlled trial.","authors":"Meng-Tzu Weng, Po-Jen Yang, Pan-Fu Liu, Chin-Hao Chang, Hsuan-Shu Lee, Jin-Chuan Sheu, Hsiao-Ching Nien","doi":"10.1007/s12072-024-10758-3","DOIUrl":"10.1007/s12072-024-10758-3","url":null,"abstract":"<p><strong>Background/aims: </strong>Nonalcoholic fatty liver disease (NAFLD) is a common liver comorbidity with considerable global consequences. This study explores the efficacy of dapagliflozin, a sodium-glucose cotransporter 2 inhibitor primarily used to manage type 2 diabetes, in reducing liver steatosis among NAFLD patients.</p><p><strong>Methods: </strong>This randomized, open-label, two-arm, parallel-group trial enrolled patients with NAFLD and a controlled attenuation parameter (CAP) score of ≥ 252 dB/m. Participants were randomized (1:1) into either the control or dapagliflozin groups. The primary outcome was the change in CAP scores, measured with FibroScan after 24 weeks.</p><p><strong>Results: </strong>The trial included 150 patients, 20 of whom (13%) had type 2 diabetes. In week 24, the dapagliflozin group had significantly lower CAP score and fatty liver grade than did the control group (266.3 ± 57.8 50 vs 298.6 ± 59.0 dB/m, respectively [p = 0.002]; 1.7 ± 0.7 vs 2.2 ± 0.8, respectively [p < 0.001]). Liver stiffness, waist circumference, and alanine transaminase levels decreased in both the dapagliflozin and control groups, but the between-group differences were nonsignificant (1.0 ± 0.3 vs 1.1 ± 0.3 [p = 0.678], 94.2 ± 12.7 vs 92.4 ± 11.1 [p = 0.382], and 28.8 ± 18.3 vs 28.3 ± 14.2 U/L [p = 0.856], respectively). In the multivariate analysis, a reduction in CAP was associated with dapagliflozin treatment (p = 0.01) and changes in BMI (p = 0.007). No adverse events were observed.</p><p><strong>Conclusion: </strong>Dapagliflozin can reduce CAP score and fatty liver grade in patients with moderate to severe NAFLD, regardless of their diabetes status.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"405-414"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease.","authors":"Mohammed Eslam, Jian-Gao Fan, Ming-Lung Yu, Vincent Wai-Sun Wong, Ian Homer Cua, Chun-Jen Liu, Tawesak Tanwandee, Rino Gani, Wai-Kay Seto, Shahinul Alam, Dan Yock Young, Saeed Hamid, Ming-Hua Zheng, Takumi Kawaguchi, Wah-Kheong Chan, Diana Payawal, Soek-Siam Tan, George Boon-Bee Goh, Simone I Strasser, Hang Dao Viet, Jia-Horng Kao, Won Kim, Seung Up Kim, Shelley E Keating, Yusuf Yilmaz, Lubna Kamani, Chia-Chi Wang, Yasser Fouad, Zaigham Abbas, Sombat Treeprasertsuk, Kessarin Thanapirom, Mamun Al Mahtab, Undram Lkhagvaa, Oidov Baatarkhuu, Ashok Kumar Choudhury, Catherine A M Stedman, Abhijit Chowdhury, A Kadir Dokmeci, Fu-Sheng Wang, Han-Chieh Lin, Jee-Fu Huang, Jess Howell, Jidong Jia, Mohamed Alboraie, Stuart K Roberts, Masato Yoneda, Hasmik Ghazinian, Aram Mirijanyan, Yuemin Nan, Cosmas Rinaldi Adithya Lesmana, Leon A Adams, Gamal Shiha, Manoj Kumar, Necati Örmeci, Lai Wei, George Lau, Masao Omata, Shiv K Sarin, Jacob George","doi":"10.1007/s12072-024-10774-3","DOIUrl":"10.1007/s12072-024-10774-3","url":null,"abstract":"<p><p>Metabolic dysfunction-associated fatty liver disease (MAFLD) affects over one-fourth of the global adult population and is the leading cause of liver disease worldwide. To address this, the Asian Pacific Association for the Study of the Liver (APASL) has created clinical practice guidelines focused on MAFLD. The guidelines cover various aspects of the disease, such as its epidemiology, diagnosis, screening, assessment, and treatment. The guidelines aim to advance clinical practice, knowledge, and research on MAFLD, particularly in special groups. The guidelines are designed to advance clinical practice, to provide evidence-based recommendations to assist healthcare stakeholders in decision-making and to improve patient care and disease awareness. The guidelines take into account the burden of clinical management for the healthcare sector.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"261-301"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing pricing and affordability of HBV treatment in Asia-Pacific region: a barrier to elimination.","authors":"Jing Chen, Jidong Jia, Hui Zhuang, Wenhong Zhang, Jin Mo Yang, Tawesak Tanwandee, Diana Payawal, Saeed Hamid, Shiv Kumar Sarin, Masao Omata, Guiqiang Wang, George Lau","doi":"10.1007/s12072-024-10744-9","DOIUrl":"10.1007/s12072-024-10744-9","url":null,"abstract":"<p><strong>Background: </strong>The Asia-Pacific (AP) region carries a substantial burden of HBV. Affordable HBV treatment is crucial to attain WHO's elimination goal. This study assesses the pricing and affordability of HBV treatment in AP.</p><p><strong>Methods: </strong>A survey conducted among APASL members from 2 Aug to 30 Oct, 2023, gathered data on antiviral HBV drugs, treatment costs covering stages of chronic hepatitis B (CHB), compensated cirrhosis (CC), hepatocellular carcinoma (HCC), liver transplant, and monitoring expenses. Drug costs for TDF and ETV were compared to international reference price (TDF: $30, ETV: $36 per person per year), generating a median price ratio (MPR) where MPR < 1 indicated an acceptable local price. Affordability was evaluated by comparing yearly CHB treatment cost to yearly minimum wage in each country/area, all converted to 2023 US$.</p><p><strong>Results: </strong>ETV costs ranged from $42 per person per year in Pakistan to $2640 in Malaysia, while TDF costs varied from $12 in mainland China to $2446 in Hong Kong. Almost all MPR exceeded 1. Affordability of HBV treatment varied, with CHB patients in Australia paying 1.4% of minimum yearly wage to get 1 year CHB treatment, in contrast to Myanmar's 78.6%. Affordability disparities were also evident for patients with CC, HCC, and liver-transplant needs, though monitoring costs were generally affordable.</p><p><strong>Conclusions: </strong>Despite patent expiration and availability of low-cost generics for TDF and ETV, HBV medication costs in Asia-Pacific region remain high. CHB treatment is generally unaffordable for patients, posing a significant barrier to HBV elimination in this endemic region.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"349-357"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of nomograms to predict outcomes for large hepatocellular carcinoma after liver resection.","authors":"Jianxing Zeng, Guixiang Chen, Jinhua Zeng, Jingfeng Liu, Yongyi Zeng","doi":"10.1007/s12072-024-10754-7","DOIUrl":"10.1007/s12072-024-10754-7","url":null,"abstract":"<p><strong>Background: </strong>Large hepatocellular carcinoma (HCC) is difficult to resect and accompanied by poor outcome. The aim was to evaluate the short-term and long-term outcomes of patients who underwent liver resection for large HCC, eventually drawing prediction models for short-term and long-term outcomes.</p><p><strong>Methods: </strong>1710 large HCC patients were recruited and randomly divided into the training (n = 1140) and validation (n = 570) cohorts in a 2:1 ratio. Independent risk factors were identified by regression model and used to establish three nomograms for surgical risk, overall survival (OS), and recurrence-free survival (RFS) in the training cohort. Model performances were assessed by discrimination and calibration. The three models were also compared with six other staging systems.</p><p><strong>Results: </strong>Platelet (PLT), gamma-glutamyl transpeptidase (GGT), albumin-bilirubin (ALBI) grade, blood transfusion and loss, resection margin, tumor size, and tumor number were established in a nomogram to evaluate surgical risk ( https://largehcc.shinyapps.io/largehcc-morbidity/ ). The model had a good prediction capability with a C-index of 0.764 and 0.773 in the training and validation cohorts. Alpha-fetoprotein (AFP), resection margin, tumor size, tumor number, microvascular invasion, Edmondson-Steiner grade, tumor capsular, and satellite nodules were considered to construct a prognostic nomogram to predict the 1-, 3- and 5-year OS ( https://largehcc.shinyapps.io/largehcc-os/ ). The C-index of the model was 0.709 and 0.702 for the training and validation cohorts. Liver cirrhosis, albumin (ALB), total bilirubin (TBIL), AFP, tumor size, tumor number, microvascular invasion, and tumor capsular were used to draw a prognostic nomogram to predict the 1-, 3- and 5-year RFS ( https://largehcc.shinyapps.io/largehcc-rfs/ ). The C-index of the model was 0.695 and 0.675 in the training and validation cohorts. The discrimination showed that the models had significantly better predictive performances than six other staging systems.</p><p><strong>Conclusions: </strong>Three novel nomograms were developed to predict short-term and long-term outcomes in patients with large HCC who underwent curative resection with adequate performance. These predictive models could help to design therapeutic interventions and surveillance for patients with large HCC.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"428-440"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden, trends, and predictions of liver cancer in China, Japan, and South Korea: analysis based on the Global Burden of Disease Study 2021.","authors":"Si Yang, Yujiao Deng, Yi Zheng, Jing Zhang, Dongdong He, Zhijun Dai, Changcun Guo","doi":"10.1007/s12072-024-10763-6","DOIUrl":"10.1007/s12072-024-10763-6","url":null,"abstract":"<p><strong>Background: </strong>Liver cancer (LC) is a major concern in the Asia-Pacific region, particularly in China, Korea, and Japan. In this study, we aimed to investigate the burden, trends, and predictions related to LC in these countries.</p><p><strong>Methods: </strong>Using data from the Global Burden of Disease Study 2021, the epidemiological characteristics [incidence, deaths, and disability-adjusted life-years (DALYs)] for LC were analysed and stratified by specific etiologies in China, Japan, and South Korea. We examined temporal trends in LC burden over the last 32 years and projected changes over the following 25 years. The risk factors associated with LC deaths and DALYs were also investigated.</p><p><strong>Results: </strong>In 2021, the highest LC-related incidence, mortality, and DALYs were recorded in China (196,637 incidents, 172,068 mortalities, and 4,890,023 DALYs), and the lowest in South Korea (18,642 incidents, 13,674 deaths, and 326,336 DALYs). South Korea recorded the highest age-standardized rates (ASRs) of incidence, mortality, and DALYs for LC (19.94 per 100,000, 14.53 per 100,000, and 354.57 per 100,000), and Japan the lowest (9.89, 7.29, and 145.74, respectively). From 1990 to 2021, LC incidents and deaths in the three countries increased, and the trends in ASRs decreased. LC incidents and deaths caused by five etiologies also increased in the past 32 years, and non-alcoholic steatohepatitis (NASH) was the largest increasing etiologies in China. Infections with hepatitis B virus remained the leading cause of LC in China and South Korea, while hepatitis C virus was the prevailing cause in Japan. High body mass index (BMI) was the most sharply increasing risk factor in China. Alcohol and drug use were the main risk factors for LC in South Korea and Japan, respectively. The LC burden in the three countries was projected to rise steadily between 2022 and 2046.</p><p><strong>Conclusions: </strong>LC remains a significant disease burden in China, Japan, and South Korea now and over the next 25 years. Regarding etiologies and risk factors, NASH and high BMI in China, alcohol use in South Korea, and drug use in Japan should receive significant attention.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"441-459"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer-associated fibroblasts in hepatocellular carcinoma: heterogeneity, mechanisms and therapeutic targets.","authors":"Yutong Li, Mawieh Hamad, Eyad Elkord","doi":"10.1007/s12072-025-10788-5","DOIUrl":"10.1007/s12072-025-10788-5","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is one of the common malignant cancers worldwide. Although immunotherapy has improved the treatment outcome in HCC, a significant percentage of patients with advanced HCC still cannot benefit from immunotherapy. Therefore, developing new targets or combination therapeutic strategies to improve the efficacy of immunotherapy is urgently needed. A deeper understanding of the mechanisms underlying immune regulation may help in this regard. The tumor microenvironment (TME) consists of a diverse set of components modulating the efficacy of immunotherapy. Cancer-associated fibroblasts (CAFs) are critical components of the TME and can regulate both tumor and immune cells through secreted cytokines and exosomes that impact various signaling pathways in target cells. CAF-derived cytokines can also participate in extracellular matrix (ECM) remodeling, thereby impacting cancer progression and tumor responsiveness to immunotherapy among other effects. A thorough understanding of the phenotypic and functional profile dynamism of CAFs may lead the way for new treatment strategies and/or better treatment outcomes in HCC patients. In this review, we outline the biomarkers and functional heterogeneity of CAFs in HCC and elaborate on molecular mechanisms of CAFs, including anti-programmed cell death protein 1 (PD-1)/PD-ligand 1 (PD-L1) immunotherapy. We also examine current clinical implications of CAFs-related targets as potential therapeutic candidates in HCC.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"325-336"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The promise of incretin-based pharmacotherapies for metabolic dysfunction-associated fatty liver disease.","authors":"Harendran Elangovan, Jenny Elizabeth Gunton, Ming Hua Zheng, Jian-Gao Fan, George Boon Bee Goh, Henning Gronbaek, Jacob George","doi":"10.1007/s12072-025-10795-6","DOIUrl":"10.1007/s12072-025-10795-6","url":null,"abstract":"<p><strong>Background: </strong>The presence of excess liver fat secondary to metabolic dysregulation represents the end-organ manifestation of a systemic disease that can progress to steatohepatitis, cirrhosis and its feared complications of clinical decompensation and hepatocellular cancer. Since metabolic dysfunction-associated fatty liver disease (MAFLD) is highly prevalent globally, there is a pressing need to augment lifestyle interventions with pharmacotherapies to ameliorate disease burden and reduce adverse liver-related events.</p><p><strong>Purpose: </strong>This review summarises current evidence for the utility of incretin mimetics in the MAFLD/MASH arena.</p><p><strong>Methods: </strong>A literature review that encompassed multiple database searches to inform the evidence base for incretin drugs in MAFLD/MASH.</p><p><strong>Results: </strong>Incretin mimetics demonstrate multifarious benefits across the metabolic diseases spectrum with mounting evidence for their role in remitting steatohepatitis and liver fibrosis. Weight loss and insulin sensitisation contribute, but additional mechanisms may also be engaged. Gastrointestinal adverse effects are common but for most, can be managed while preserving the hepatic and cardiometabolic benefits.</p><p><strong>Conclusion: </strong>The literature reveals benefits from incretin-based therapies for MASH, but data on whether they improve long-term hepatic outcomes are awaited to support their future incorporation into routine clinical care.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"337-348"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing non-invasive monitoring of the therapeutic response to NSBBs in portal hypertension: is machine learning the answer?","authors":"Annalisa Berzigotti","doi":"10.1007/s12072-025-10804-8","DOIUrl":"10.1007/s12072-025-10804-8","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"302-303"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the evaluation and management of MAFLD: a call for comprehensive assessments and social work integration.","authors":"Han Wang, Huanhuan Feng, Wenchao Zhou","doi":"10.1007/s12072-024-10735-w","DOIUrl":"10.1007/s12072-024-10735-w","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"472-473"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic (dysfunction)-associated fatty liver disease metrics and contributions: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1007/s12072-024-10771-6","DOIUrl":"10.1007/s12072-024-10771-6","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"478-479"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}