JHEP Reports最新文献

{"title":"Primary percutaneous stenting for palliative biliary drainage of patients with malignant hilar biliary obstruction: TESLA trial","authors":"Stijn Franssen ,&nbsp;Merve Rousian ,&nbsp;Victorien van Verschuer ,&nbsp;Marco Bruno ,&nbsp;Michail Doukas ,&nbsp;Lydi van Driel ,&nbsp;Marjolein Homs ,&nbsp;Behnam Mohseny ,&nbsp;Roeland de Wilde ,&nbsp;Jeroen de Jonge ,&nbsp;Wojciech Polak ,&nbsp;Robert Porte ,&nbsp;Diederik Bijdevaate ,&nbsp;Adriaan Moelker ,&nbsp;Bas Groot Koerkamp","doi":"10.1016/j.jhepr.2025.101541","DOIUrl":"10.1016/j.jhepr.2025.101541","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Palliative patients with malignant hilar biliary obstruction typically undergo endoscopic or internal/external percutaneous biliary drainage. Both approaches may cause bacterial colonization of the bile ducts, requiring multiple reinterventions. The 90-day mortality rate after palliative drainage is reported to be up to 36%. Few patients become eligible for systemic treatment. Primary percutaneous stenting may avoid infectious complications. The aim of this study was to investigate primary percutaneous stenting in palliative patients with malignant hilar biliary obstruction.</div></div><div><h3>Methods</h3><div>We performed a single-arm phase II trial. Primary percutaneous stenting was performed with uncovered self-expandable metal stents across the hilar tumor without crossing the ampulla. The puncture tract was sealed without leaving an external drain. Outcomes included drainage-related severe complications and the proportion of patients receiving systemic treatment after drainage.</div></div><div><h3>Results</h3><div>From October 2020 until June 2023, 67 patients were included, with perihilar cholangiocarcinoma in 27 patients (40.3%), intrahepatic cholangiocarcinoma in 23 patients (34.3%), gallbladder cancer in nine patients (13.4%), and other tumors in eight patients (12.0%). Drainage-related severe complications within 90 days were observed in 12 patients (17.9%); two patients (3.0%) developed acute cholecystitis, one patient (1.5%) had a biliary leak, three patients (4.5%) had hemorrhage, and six patients (9.0%) had persistent jaundice. No drainage-related 90-day mortality was observed. Cholangitis or pancreatitis was never observed after the first drainage. Palliative systemic treatment was started in 42 patients (62.7%).</div></div><div><h3>Conclusions</h3><div>Primary percutaneous stenting for patients with malignant hilar biliary obstruction had a low incidence of drainage-related complications without any cholangitis or pancreatitis after the first drainage. Palliative systemic treatment was never withheld because of drainage-related complications or inadequate drainage. These results compare favorably to both endoscopic and internal/external percutaneous drainage.</div></div><div><h3>Impact and implications</h3><div>This study demonstrates that primary percutaneous stenting in patients with malignant hilar biliary obstruction results in a low rate of drainage-related complications and enables initiation of systemic therapy in the majority of patients. These findings are clinically relevant for gastroenterologists, interventional radiologists, and oncologists aiming to optimize palliative care while minimizing infectious risks. The approach may offer a safe and effective alternative to conventional drainage strategies, although confirmation in comparative trials is needed to support broader implementation.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 11","pages":"Article 101541"},"PeriodicalIF":7.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ‘social gradient' in primary liver cancer in France: A national observational study","authors":"Marie Strigalev ,&nbsp;David Fuks ,&nbsp;Sandrine Katsahian ,&nbsp;Lucia Parlati ,&nbsp;Ugo Marchese ,&nbsp;Maria Conticchio ,&nbsp;Charlotte Ronde-Roupie ,&nbsp;Alexandra Nassar ,&nbsp;Alix Dhote ,&nbsp;Vincent Mallet ,&nbsp;Stylianos Tzedakis","doi":"10.1016/j.jhepr.2025.101585","DOIUrl":"10.1016/j.jhepr.2025.101585","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Social deprivation has been associated with primary liver cancer (PLC); however, its impact on access to curative treatment and survival remains uncertain. We assessed the effect of deprivation on healthcare access and evaluated whether care centralization could improve PLC management at a national level.</div></div><div><h3>Methods</h3><div>We conducted a retrospective longitudinal cohort study using the French National Discharge Database (2017–2021), including all adult patients with PLC. Deprivation was the primary exposure. Primary and secondary outcomes were access to curative treatment (surgery, transplantation, or ablation) and mortality. Associations were assessed using adjusted odds ratios (aORs) and hazard ratios (aHRs) derived from random-effects logistic and Cox models, clustered by French regional departments. G-computation was applied to estimate the absolute effect of centralization (treatment within referral hospitals) on curative treatment access among deprived patients.</div></div><div><h3>Results</h3><div>Among 62,351 patients (median age [IQR], 71 [63–78] years; 70.8% male), 45% (n = 27,872) were classified as deprived. Deprivation was associated with reduced access to curative treatment (aOR 0.89; 95% CI 0.85–0.92; <em>p &lt;</em>0.001) and higher mortality (aHR 1.03; 95% CI 1.01–1.05; <em>p &lt;</em>0.001). These associations were not observed among patients treated in referral hospitals (aOR 1.03; 95% CI 0.98–1.09; aHR 1.02; 95% CI 0.98–1.06). Improving access to referral hospitals was estimated to increase the probability of receiving curative treatment by 25% (95% CI 24–26), potentially benefiting 811 deprived patients per year (range, 730–895).</div></div><div><h3>Conclusions</h3><div>Deprivation reduced access to curative treatment and increased mortality among patients with primary liver cancer in France. Care centralization could help mitigate these disparities and improve outcomes.</div></div><div><h3>Impact and implications</h3><div>Social deprivation is known to increase the risk of developing primary liver cancer (PLC) and to reduce survival. However, it has been unclear if this is due to late-stage diagnoses or limited access to treatments, as earlier studies mostly considered factors like race, ethnicity, sex, and insurance status. Our study highlighted that socially deprived patients with PLC in France face reduced access to curative and palliative treatments, resulting in lower overall survival rates. A key finding was that the negative impact of social deprivation was mitigated by care centralization – when patients were diagnosed or treated in referral centers, social deprivation no longer influenced access to curative treatments or mortality outcomes. These findings support the need for centralized PLC management strategies across the country to improve care outcomes for socioeconomically disadvantaged individuals.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 11","pages":"Article 101585"},"PeriodicalIF":7.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive tests for MetALD and alcohol-related liver disease","authors":"Stine Johansen ,&nbsp;Maja Thiele ,&nbsp;Aleksander Krag","doi":"10.1016/j.jhepr.2025.101569","DOIUrl":"10.1016/j.jhepr.2025.101569","url":null,"abstract":"<div><div>Metabolic- and alcohol-related liver disease (MetALD) and alcohol-related liver disease (ALD) are major drivers of the global burden of cirrhosis. While metabolic dysfunction-associated steatotic liver disease (MASLD) affects nearly one-third of the global population, ALD and MetALD, though far less common, account for a disproportionately high rate of liver-related complications and deaths. Despite this, research and clinical focus on ALD and MetALD remain limited. A critical barrier is the late stage at which these conditions are typically diagnosed, often after the onset of decompensation. In this review, we explore the potential of non-invasive tests (NITs) to change the diagnostic landscape of ALD and MetALD. NITs offer a practical and scalable means to detect liver disease at earlier, compensated stages, before symptoms emerge, thereby opening a window for timely intervention. Beyond diagnosis, these tools also serve important roles in risk assessment, disease monitoring, and evaluating treatment response. As interest in therapeutic developments for ALD and MetALD grows, NITs are expected to become central to trial design, helping to identify suitable participants, assess ongoing alcohol use, and monitor efficacy without reliance on invasive biopsies. We also discuss broader strategies necessary to support early detection, including policy changes, stigma reduction, and improved access to care. Finally, we consider emerging biomarkers and their promise in advancing precision medicine approaches tailored to this high-risk patient population.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 11","pages":"Article 101569"},"PeriodicalIF":7.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copyright and information","authors":"","doi":"10.1016/S2589-5559(25)00258-7","DOIUrl":"10.1016/S2589-5559(25)00258-7","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 9","pages":"Article 101576"},"PeriodicalIF":7.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board page","authors":"","doi":"10.1016/S2589-5559(25)00256-3","DOIUrl":"10.1016/S2589-5559(25)00256-3","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 9","pages":"Article 101574"},"PeriodicalIF":7.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statins in MASLD: Challenges and future directions","authors":"Xiao-Dong Zhou ,&nbsp;Mark D. Muthiah ,&nbsp;Ming-Hua Zheng","doi":"10.1016/j.jhepr.2025.101372","DOIUrl":"10.1016/j.jhepr.2025.101372","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 9","pages":"Article 101372"},"PeriodicalIF":7.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparate patterns of disease time burden in patients with HCC on immunotherapy or tyrosine kinase inhibitors","authors":"Rex Wan-Hin Hui ,&nbsp;Matthew Shing-Hin Chung ,&nbsp;Lu Li ,&nbsp;Xianhua Mao ,&nbsp;Chi-Leung Chiang ,&nbsp;Carlos King-Ho Wong ,&nbsp;Ian Chi-Kei Wong ,&nbsp;Ka-Shing Cheung ,&nbsp;Man-Fung Yuen ,&nbsp;Wai-Kay Seto ,&nbsp;Lung-Yi Mak","doi":"10.1016/j.jhepr.2025.101578","DOIUrl":"10.1016/j.jhepr.2025.101578","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>While cancer survivorship for hepatocellular carcinoma (HCC) has improved, associated disease time burden in patients taking systemic therapies remains poorly understood. In this study, we used days at home (DAH), a patient-centered metric, to compare the disease time burden between patients taking immunotherapies and tyrosine kinase inhibitors (TKIs).</div></div><div><h3>Methods</h3><div>Patients with HCC receiving systemic therapy from 2008 to 2023 were identified from a population-based cohort. Patients were classified based on the use of immunotherapy (nivolumab, pembrolizumab, atezolizumab, durvalumab, tremelimumab, and ipilimumab; including monotherapies or combinations) or TKIs (lenvatinib, sorafenib, cabozantinib, and regorafenib). The primary outcome was DAH, defined as days alive and not requiring healthcare utilization within the first year of systemic therapy.</div></div><div><h3>Results</h3><div>This study included 4,677 patients (immunotherapy, 578; TKIs, 3,410; both immunotherapy and TKIs, 689). Compared with TKIs, immunotherapy use was associated with higher 1-year overall survival (58.1% <em>vs.</em> 34.2%, respectively, <em>p</em> &lt;0.001) and higher mean DAH (223.1 <em>vs.</em> 183.3 days, respectively, <em>p</em> &lt;0.001). Immunotherapy was associated with fewer days spent on inpatient stays and emergency department attendance, but more days spent on day procedures and investigations (all <em>p</em> &lt;0.01). Immune-related adverse events (irAEs) occurred in 12.3% of patients taking immunotherapy, and independently predicted lower probability of achieving DAH ≥180 days within the first year of therapy (hazard ratio 0.523, 95% CI 0.290–0.942, <em>p</em> = 0.031). Patients taking immunotherapy with irAEs had comparable DAH to patients taking TKIs (<em>p</em> = 0.469).</div></div><div><h3>Conclusions</h3><div>Immunotherapy was associated with reduced disease time burden in HCC compared with TKIs. However, this benefit was dampened by the occurrence of irAEs. Our data has quality-of-life implications, and could influence patients’ treatment decisions.</div></div><div><h3>Impact and implications</h3><div>This study utilized days at home (DAH), a patient-centered metric, to assess the disease time burden in patients with advanced hepatocellular carcinoma taking systemic therapies. We demonstrated that immunotherapy was associated with higher DAH compared with tyrosine kinase inhibitor treatment, although this benefit was dampened by the occurrence of immune-related adverse events. These findings have quality-of-life implications and can be used for patient counselling.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 11","pages":"Article 101578"},"PeriodicalIF":7.5,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated IgG elevation in patients with persistently normal transaminases does not affect the outcome of autoimmune hepatitis","authors":"Álvaro Díaz-González ,&nbsp;Ida Schregel ,&nbsp;Lorena Carballo ,&nbsp;Carmen Álvarez-Navascués ,&nbsp;Enrique Frisancho-Morales ,&nbsp;Mireia Miquel ,&nbsp;Montserrat García Retortillo ,&nbsp;Judith Gómez ,&nbsp;Diana Horta ,&nbsp;Beatriz Mateos ,&nbsp;Bastian Engel ,&nbsp;Felix Volmer ,&nbsp;María del Barrio ,&nbsp;Sergio Rodríguez-Tajes ,&nbsp;Ignasi Olivas ,&nbsp;Johannes Hartl ,&nbsp;Carla Amaral González ,&nbsp;Manuel Hernández-Guerra ,&nbsp;Inmaculada Castello ,&nbsp;Indhira Pérez-Medrano ,&nbsp;María-Carlota Londoño","doi":"10.1016/j.jhepr.2025.101562","DOIUrl":"10.1016/j.jhepr.2025.101562","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>The goal of treatment for autoimmune hepatitis is to achieve a complete biochemical response, defined as normalization of transaminases and immunoglobulin G (IgG) levels. Recent data suggest that IgG normalization does not significantly affect survival. We evaluated the impact of persistently elevated IgG levels (IgGe) and IgG flares (IgGf) on fibrosis progression and cirrhosis development.</div></div><div><h3>Methods</h3><div>This retrospective multicenter cohort study included 493 patients with autoimmune hepatitis and persistently normal transaminase levels during follow-up. The inverse probability of treatment weighting (IPTW) propensity score method was used to balance the cohorts.</div></div><div><h3>Results</h3><div>Three hundred forty-nine (70.8%) patients had persistently normal IgG (IgGn) levels, 89 (18.1%) had IgGe, and 55 (11.1%) had IgGf during follow-up. After a median follow-up of 6.2 years (IQR 4.1–10.1 years) with normal transaminase levels, median liver stiffness measurement (LSM) values remained stable, with no significant differences between groups. During the follow-up, 24 patients developed cirrhosis. Predictive factors for cirrhosis were age (hazard ratio [HR] 1.10, <em>p</em> &lt;0.001), albumin (HR 0.20, <em>p</em> &lt;0.001), IgG (HR 1.00, <em>p</em> = 0.001), and platelet count (HR 0.99, <em>p</em> = 0.001) at diagnosis; LSM (HR 1.30, <em>p</em> &lt;0.001) at transaminase normalization; and transaminase normalization at 6 months (HR 0.24, <em>p</em> = 0.025). In the multivariate analysis, only LSM was independently associated with a higher risk of developing cirrhosis. After IPTW application, elevated IgG (IgGe or IgGf) did not affect fibrosis progression (<em>p</em> = 0.275) or cirrhosis development (<em>p</em> = 0.211).</div></div><div><h3>Conclusions</h3><div>Persistent or temporary serum IgG elevation in patients with normal transaminase levels did not significantly affect autoimmune hepatitis disease progression, thus challenging the current definition of complete biochemical response.</div></div><div><h3>Impact and implications</h3><div>The body of evidence showing a lesser impact of immunoglobulin G (IgG)values on outcomes in patients with autoimmune hepatitis (AIH) is growing. However, there is still a lack of robust information on the long-term outcomes, especially in patients who achieve persistent transaminase normalization. Persistently elevated IgG or IgG flares in patients with persistently normal transaminases do not seem to affect outcomes in patients with AIH. These results challenge the current definition of complete biochemical response in patients with AIH. Transaminase level normalization appeared to be the best treatment endpoint.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 11","pages":"Article 101562"},"PeriodicalIF":7.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pathomics-integrated multimodal model to evaluate chemoimmunotherapy efficacy in unresectable intrahepatic cholangiocarcinoma","authors":"Qi-Hang Cao ,&nbsp;Han Li ,&nbsp;Peng-Fei Sun ,&nbsp;Dong-Hai Lu ,&nbsp;Bao-Wen Tian ,&nbsp;Ke-Fan Jiao ,&nbsp;Jin-Cheng Tian ,&nbsp;Yu-Xuan Wang ,&nbsp;Ji-Sen Jia ,&nbsp;Zhao-Han Zhang ,&nbsp;Qiao He ,&nbsp;Sheng-Xuan Peng ,&nbsp;Dao-Lin Zhang ,&nbsp;Zhao-Ru Dong ,&nbsp;Dong-Xu Wang ,&nbsp;Tao Li","doi":"10.1016/j.jhepr.2025.101557","DOIUrl":"10.1016/j.jhepr.2025.101557","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; Aims&lt;/h3&gt;&lt;div&gt;Chemoimmunotherapy has emerged as the first-line therapy for unresectable intrahepatic cholangiocarcinoma (ICC). However, durable clinical responses are observed in less than 30% of patients, necessitating biomarkers of survival benefit. Thus, the aim of this study was to develop and validate a pathomics-based prognostic signature for patients with ICC receiving chemoimmunotherapy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This multicenter study included patients with ICC with biopsy samples. Pathomics features were extracted from digital H&amp;E-stained images, and the pathomics signature for ICC (PS-ICC) was developed by machine learning (ML). SHapley Additive exPlanations provided algorithmic explanation, and The Cancer Genome Atlas database supported biological interpretation. We explored the potential of PS-ICC as surrogate index compared with radiological response.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Based on pretreatment specimens, 189 patients receiving chemoimmunotherapy were included. Univariate Cox analysis demonstrated that the PS-ICC status from a pathomics-driven ML model was associated with overall survival (OS) in patients with unresectable ICC undergoing chemoimmunotherapy (training cohort: hazard ratio (HR) = 0.09, 95% CI, 0.05–0.14, &lt;em&gt;p&lt;/em&gt; &lt;0.001; validation cohort: HR = 0.20, 95% CI 0.08–0.47, &lt;em&gt;p&lt;/em&gt; &lt;0.001). PS-ICC characterized tumor microenvironment heterogeneity, with lower scores correlating with reduced M0 macrophage infiltration (&lt;em&gt;p&lt;/em&gt; = 0.043) and programmed death-ligand 1 expression and programmed death-1 checkpoint pathways (&lt;em&gt;p&lt;/em&gt; = 0.002). In addition, PS-ICC status could serve as a surrogate marker for OS compared with the Response Evaluation Criteria in Solid Tumors Version1.1 at 3 months post treatment (training cohort: AUC at 1 year: 0.868 &lt;em&gt;vs.&lt;/em&gt; 0.701; 2 year: 0.787 &lt;em&gt;vs.&lt;/em&gt; 0.694). The PS-ICC-integrated nomogram outperformed conventional prognostic model in accuracy (Concordance index: 0.80 &lt;em&gt;vs.&lt;/em&gt; 0.71).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The PS-ICC demonstrates potential as a surrogate endpoint for survival prediction in patients with ICC undergoing chemoimmunotherapy, with biological plausibility evidenced by its tumor microenvironment associations. Prospective trials are warranted to confirm clinical utility.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Impact and implications&lt;/h3&gt;&lt;div&gt;This study developed and validated a machine learning-based pathomics signature that accurately predicts overall survival in patients with intrahepatic cholangiocarcinoma (ICC) receiving chemoimmunotherapy. The pathomics signature for ICC provides a biologically grounded, pretreatment biomarker to stratify patients for chemoimmunotherapy, potentially reducing overtreatment and guiding personalized strategies. By demonstrating strong correlation with overall survival, this signature could serve as a surrogate endpoint in clinical trials, thereby accelerating drug develop","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 11","pages":"Article 101557"},"PeriodicalIF":7.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world work productivity is impaired in people with metabolic dysfunction-associated steatotic liver disease in the USA","authors":"Shraddha Shinde ,&nbsp;Mary E. Rinella ,&nbsp;Mark L. Hartman ,&nbsp;David Schapiro ,&nbsp;Victoria Higgins ,&nbsp;Andrea Leith ,&nbsp;James Pike ,&nbsp;Quentin M. Anstee","doi":"10.1016/j.jhepr.2025.101558","DOIUrl":"10.1016/j.jhepr.2025.101558","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; Aims&lt;/h3&gt;&lt;div&gt;The impact of metabolic dysfunction-associated steatohepatitis (MASH) on patient-reported outcomes is poorly understood. We assessed work productivity burden in a real-world population with suspected/confirmed MASH, comparing work productivity and symptoms across subgroups (risk status, age, BMI, and comorbidities) in the USA using secondary data from Adelphi Real World MASH Disease Specific Programmes™, cross-sectional surveys of physicians and consulting patients in 2019 and 2022.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Physicians (hepatologists, gastroenterologists, and endocrinologists) reported sociodemographic data and signs/symptoms for eight or fewer consecutive participants with MASH. Participants voluntarily completing questionnaires that assessed work productivity, health status, and quality of life/symptoms were categorized with low-, indeterminate-, or high-risk MASH using physician-stated fibrosis stage and derived risk categories. Principal components factor analysis identified factors from MASH signs and symptoms. Elastic net regression determined features associated with work productivity impairment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In total, 87 physicians and 429 individuals with MASH provided data. The impact of MASH on activities was greater in high-versus low-risk MASH (activity impairment score: high risk, 30.8%; low risk, 17%; &lt;em&gt;p&lt;/em&gt; &lt;0.001 across all risk categories). Overall work impairment scores were 18.8% in low-risk and 19.9% in high-risk MASH. Of the 14 physician-reported signs/symptoms, 11 were significantly associated with physician-stated fibrosis stage and/or derived risk category. Two clusters of signs and symptoms (‘memory loss/swelling legs/abdomen’ and ‘fatigue/sleep disturbance/insomnia/general weakness’) and female sex were the strongest work impact predictors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Activity impairment was greater in participants with high-risk MASH, whereas overall work impairment was comparable, almost 20%, in low- and high-risk MASH. Non-specific symptoms of fatigue, sleep disturbance, and general weakness associated with MASH and other conditions predicted work impact in low-risk MASH. Thus, early detection and management of MASH could ameliorate work impairment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Impact and implications&lt;/h3&gt;&lt;div&gt;Even in its early stages, when otherwise asymptomatic, metabolic dysfunction-associated steatohepatitis (MASH) may impact the ability to work. Using the Work Productivity and Activity Impairment: Specific Health Problem (WPAI:SHP) questionnaire, we identified activity and overall work impairment in people with high- and low-risk MASH. We found a link between difficulty working and other signs, such as tiredness, sleep disturbance, and general weakness, in low-risk MASH that are not specific to MASH but can be associated with liver health. These general, non-specific signs could represent possible early warning signs preceding ","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 11","pages":"Article 101558"},"PeriodicalIF":7.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}