Liver International最新文献

{"title":"Safety Choice Drivers of the Coming Treatment Options for Non-Cirrhotic Metabolic Steatohepatitis","authors":"Alessandra Mangia,&nbsp;Luca V. C. Valenti","doi":"10.1111/liv.70271","DOIUrl":"https://doi.org/10.1111/liv.70271","url":null,"abstract":"<p>Metabolic dysfunction associated steatohepatitis (MASH), formerly known as NASH, represents one of the leading causes of chronic liver disease worldwide. Its high prevalence is driven by insulin resistance, obesity and type 2 diabetes (T2D) and is associated with cardiovascular disease. The main driver of liver damage is fat accumulation in hepatocytes leading to inflammation and fibrosis development. People with MASH and clinically significant fibrosis (stage F2/F3) are ‘at risk’ of progressing to cirrhosis and hepatocellular carcinoma and are considered in need of treatment. Metabolic drivers of MASH originating outside the liver, for example, from the adipose tissue and the gut, and genetic heterogeneity contribute to making the prevalent pathogenetic factor difficult to dissect at an individual level. In this scenario, the Food and Drug Administration's conditional approval of the liver-directed thyroid hormone receptor beta agonist Resmetirom as the first pharmacological treatment for MASH last March 2024 and the expected extension of the glucagon-like protein-1 receptor agonist Semaglutide indication from diabetes and obesity to MASH mark a key milestone. Both drugs are also under evaluation by the European Medicines Agency. The proven efficacy of these compounds in clinical trials needs to be balanced against safety profiles and patient preferences. To investigate future trajectories and possible uses as mono-therapy or in combination, we examined available results of clinical trials and real-life studies. Despite the need to await the final results of outcome studies to exclude any possible challenges for both compounds, safety profiles and external factors including reimbursement policies or supply limitations may currently guide the individual choice.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 9","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144843740","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":"Real-World Assessment of Liver Corrected T1 and Magnetic Resonance Elastography in Predicting Liver Disease Progression","authors":"Kathleen E. Corey,&nbsp;Nabih Nakrour,&nbsp;Emily D. Bethea,&nbsp;Jessica E. Shay,&nbsp;Karin L. Andersson,&nbsp;Irun Bhan,&nbsp;Lawrence S. Friedman,&nbsp;Avinash R. Kambadakone,&nbsp;Laura E. Dichtel,&nbsp;Raymond T. Chung,&nbsp;Mukesh Harisinghani","doi":"10.1111/liv.70280","DOIUrl":"https://doi.org/10.1111/liv.70280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clinical guidelines emphasise identifying patients at risk of chronic liver disease progression. To avoid biopsy drawbacks, noninvasive imaging tests (NITs) have become part of standard-of-care. We assessed the real-world clinical profile, referral trends, and use of magnetic resonance imaging (MRI)-based tests, multiparametric MRI (mpMRI) and magnetic resonance elastography (MRE), as part of chronic liver disease management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients referred for abdominal imaging as part of standard-of-care were eligible for inclusion irrespective of liver aetiology or referral pathway. Liver fibrosis was assessed using MRE and disease severity using mpMRI (disease activity [iron-corrected T1, cT1], liver fat content [LFC] and iron). <i>T</i>-tests were used for group comparisons; Kaplan–Meier analyses for disease progression and area under the receiver operating characteristic (AUC) for diagnostic accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over 18 months, 256 patients (53 years, 51% female, 48% with BMI &gt; 30 kg/m²) were referred for liver imaging. The majority (66%) had steatotic liver disease (SLD). Of those with low MRE (73%) and low FIB-4 (42%), 36% had elevated cT1 (&gt; 875 ms). Those with MRE &gt; 5 kPa had cT1 &gt; 875 ms. During follow-up, those with low MRE (&lt; 3.14 kPa) but elevated cT1 (&gt; 800 ms) had significant disease worsening (HR: 3.1, <i>p</i> = 0.0035) compared to all others. In the SLD group, cT1 (AUC: 0.71) outperformed LFC (AUC: 0.64) and MRE (AUC: 0.53) in predicting disease progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Regardless of aetiology, patients with low fibrosis risk (MRE) but high disease activity (cT1) face a three-times higher risk of progression. Integrating both biomarkers into standard care, especially for SLD, can guide management adjustments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 9","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833274","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":"Evaluating and Optimizing the MAGIC-D Model in Advanced Biliary Tract Cancer: Toward Enhanced Clinical Utility","authors":"Yichen Zheng,&nbsp;Ji Ma","doi":"10.1111/liv.70291","DOIUrl":"https://doi.org/10.1111/liv.70291","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 9","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832588","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":"Reply to ‘Beyond Confidence Intervals: The Importance of Prediction Intervals in Meta-Analyses’, by Myriam Ayari Et al.","authors":"Sreeram Pannala,&nbsp;Babu P. Mohan","doi":"10.1111/liv.70290","DOIUrl":"https://doi.org/10.1111/liv.70290","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 9","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832589","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":"Angiogenic Signalling and HBV Immune Escape Variants: Synergistic Determinants of Transplant-Free Survival in Acute Liver Failure","authors":"Jie Yang,&nbsp;Shumei Li,&nbsp;Bing Liu","doi":"10.1111/liv.70235","DOIUrl":"https://doi.org/10.1111/liv.70235","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 9","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144814584","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":"Probiotics Prevent Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt: A Randomised Controlled Trial","authors":"Xin Quan,&nbsp;Ying Li,&nbsp;Xiuling Ye,&nbsp;Bo Wei,&nbsp;Yang Tai,&nbsp;Shuaijie Qian,&nbsp;Zhidong Wang,&nbsp;Linhao Zhang,&nbsp;Xu Guo,&nbsp;Huan Tong,&nbsp;Hao Wu","doi":"10.1111/liv.70289","DOIUrl":"https://doi.org/10.1111/liv.70289","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Hepatic encephalopathy (HE) is the most common complication of cirrhosis after transjugular intrahepatic portosystemic shunt (TIPS) and is closely related to intestinal dysbiosis. The efficacy of probiotics in improving minimal HE (MHE) has been well studied, while the role of probiotics for the primary prophylaxis of overt HE (OHE) after TIPS has not been established. We aimed to determine whether Live Combined Bifidobacterium and Lactobacillus Tablets, a commonly used probiotic preparation in China, reduced the risk of post-TIPS HE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted an open-label, randomised, blank-controlled trial of 142 patients with cirrhosis receiving TIPS. Patients were randomly assigned to receive probiotics (2 g three times daily) or not. The primary outcome was the incidence of OHE within 24 weeks after TIPS. The secondary outcomes were improvement in cognitive function [defined by the number connection test-A (NCT-A) and digit symbol test (DST)] and the incidence of other cirrhosis-related complications at 24 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incidence of post-TIPS OHE was 51.4% in the control group (<i>n</i> = 70), which was significantly lower in the probiotics group (<i>n</i> = 72, 36.1%, Fine-Grey <i>p</i> = 0.043). In the subgroup of patients without post-TIPS OHE, liver transplantation or death, there was no significant difference in DST and NCT-A tests at 24 weeks compared with baseline in the control group. By contrast, both DST [31.5 (26.4–39.3) vs. 34.5 (29.8–43.0), <i>p</i> &lt; 0.0001] and NCT-A [53.8 (43.3–71.2) vs. 46.6 (40.2–64.4), <i>p</i> = 0.0045] significantly improved at 24 weeks in the probiotics group. There was no significant difference in other cirrhosis-related complications between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Live Combined Bifidobacterium and Lactobacillus Tablets might reduce the risk of OHE and improve cognitive function in cirrhosis patients receiving TIPS for variceal bleeding without previous OHE. Multicenter studies should be performed to provide further evidence.</p>\u0000 \u0000 <p>Trial Registration: Chictr.org: ChiCTR2200062996.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 9","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144814689","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":"Breaking Barriers for Intensive Care Admission in Patients With Advanced HCC on Immunotherapy","authors":"Marta Fortuny,&nbsp;Leonardo G. da Fonseca,&nbsp;Manon Allaire,&nbsp;Rocío Sánchez,&nbsp;Jean-Charles Nault,&nbsp;Massimo Iavarone,&nbsp;Sofia Ridolfo,&nbsp;Sonia Pascual,&nbsp;Raquel Jimeno,&nbsp;Mariona Calvo,&nbsp;Raimon Rifà,&nbsp;Marco Sanduzzi-Zamparelli,&nbsp;Natalia Jiménez-Esquivel,&nbsp;Sarah Mouri,&nbsp;Mercedes Iñarrairaegui,&nbsp;Josepmaria Argemi,&nbsp;Tania Hernaez,&nbsp;José Enrique Lorenzo-Barreto,&nbsp;María Teresa Ferrer,&nbsp;Susana Coll,&nbsp;Ángela Lamarca,&nbsp;Juan Ignacio Marin,&nbsp;Enric Reverter,&nbsp;Ana María López,&nbsp;Alberto Lue,&nbsp;María Varela,&nbsp;Ana Matilla,&nbsp;Javier Fernández,&nbsp;Maria Reig","doi":"10.1111/liv.70264","DOIUrl":"https://doi.org/10.1111/liv.70264","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Intensive Care Unit (ICU) admission is usually denied to patients with advanced hepatocellular carcinoma (HCC) due to the perceived poor prognosis associated with both cirrhosis and liver cancer. However, immunotherapy based on immune checkpoint inhibitors (ICI) has transformed the treatment landscape, and the role of critical care is becoming more relevant in managing adverse events. We aim to assess the outcome of patients with advanced HCC treated with ICI admitted to the ICU.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated patients treated with ICI combinations across 20 medical centres globally between November 2012 and April 2024. Demographic data, ICI types, causes of admission, organ support, and mortality in the short and medium term were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1065 patients, 47 (4.4%) were admitted to the ICU. Most were male (76.6%) with cirrhosis (93.6%), and 59.7% received ICI as first-line therapy. The primary reasons for ICU admission were immune-related adverse events (irAE) in 46.8% and variceal bleeding in 29.8%. The median time to ICU admission was 115 days [IQR 38–202] after the initiation of ICI treatment. Among patients admitted due to irAEs, the median time was 51 days [IQR 31–137]. ICU mortality was 25.5%. Two-thirds were alive 28 days post-ICU discharge, with 3- and 6-month survival rates of 83% and 69%. Of the 61.3% of survivors, they were rechallenged with ICI or started new HCC therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>irAEs are the main cause of ICU admission in patients with advanced HCC receiving ICI. Despite the severity, 66% were discharged, and nearly half resumed treatment. These findings highlight the vital role of ICU care in managing HCC patients, challenging the notion of denying them intensive care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 9","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144814674","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":"NSBBs, EBL or Combined Therapy for High-Risk Varices: A Systematic Review and Meta-Analysis","authors":"Sreeram Pannala,&nbsp;Babu P. Mohan","doi":"10.1111/liv.70288","DOIUrl":"https://doi.org/10.1111/liv.70288","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 9","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144814675","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":"Author Response: Unpacking the ‘Four-Support’ Model: Towards Contextual Adaptation in HCV Care Cascade","authors":"Peng Xu,&nbsp;Jian Li","doi":"10.1111/liv.70284","DOIUrl":"https://doi.org/10.1111/liv.70284","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 9","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811156","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":"Chronic Nanoplastic Exposure as a Novel Risk Amplifier for MASLD Progression","authors":"Jiayi Guan,&nbsp;Yuan Ji,&nbsp;Mingxian Chen","doi":"10.1111/liv.70266","DOIUrl":"https://doi.org/10.1111/liv.70266","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 9","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144782220","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}