A global action agenda for turning the tide on fatty liver disease
- PMID: 37540183
- PMCID: PMC10789386
- DOI: 10.1097/HEP.0000000000000545
A global action agenda for turning the tide on fatty liver disease
Abstract
Background and aims: Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care.
Approach and results: We developed an aligned, prioritized action agenda for the global fatty liver disease community of practice. Following a Delphi methodology over 2 rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the action priorities using Qualtrics XM, indicating agreement using a 4-point Likert-scale and providing written feedback. Priorities were revised between rounds, and in R2, panelists also ranked the priorities within 6 domains: epidemiology, treatment and care, models of care, education and awareness, patient and community perspectives, and leadership and public health policy. The consensus fatty liver disease action agenda encompasses 29 priorities. In R2, the mean percentage of "agree" responses was 82.4%, with all individual priorities having at least a super-majority of agreement (> 66.7% "agree"). The highest-ranked action priorities included collaboration between liver specialists and primary care doctors on early diagnosis, action to address the needs of people living with multiple morbidities, and the incorporation of fatty liver disease into relevant non-communicable disease strategies and guidance.
Conclusions: This consensus-driven multidisciplinary fatty liver disease action agenda developed by care providers, clinical researchers, and public health and policy experts provides a path to reduce the prevalence of fatty liver disease and improve health outcomes. To implement this agenda, concerted efforts will be needed at the global, regional, and national levels.
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
Conflict of interest statement
Jeffrey V. Lazarus is on the speakers’ bureau for AbbVie, Gilead Sciences, Intercept, Janssen, Novo Nordisk, and ViiV. He consults for Novavax. He received grants from AbbVie, Gilead, MSD, and Roche. He has other interests with EASL Public Health and Policy Committee, HIV Outcomes, ISGlobal, the “Generalitat de Catalunya” through the CERCA Program, and SHARE Global Health Foundation. Henry E. Mark consults for the European Association for the Study of The Liver (EASL). Alina M. Allen consults, advises, and received grants from Novo Nordisk. She received grants from Pfizer and Target Pharma. Patrizia Carrieri received grants from Intercept and MSD. Mazen Noureddin consults, advises, and received grants from Echosens, Gilead, GlaxoSmithKline, Madrigal, Novo Nordisk, OWL, Pfizer, Roche, Siemens, Terns, and Takeda. He consults, advises, and owns stock in Cytodyn. He consults and advises 89BIO, Altimmune, Boehringer Ingelheim, Merck, and Prespecturm. He received grants from Allergan, Akero, Bristol Myers Squibb, Conatus, Corcept, Enanta, Gilead, Galectin, GENFIT, Novartis, Shire, and Zydus. He received grants and owns stock in Viking. He is employed by Echosens and Incytes and owns stock in Rivus Pharma, CIMA, and ChronWell. William Alazawi consults, advises, is on the speakers’ bureau, and received grants from Gilead. He consults, advises, and received grants from, AstraZeneca, GlaxoSmithKline. He advises Novo Nordisk. He is on the speakers’ bureau for UCB. He owns stock in Metadeq. Naim Alkhouri consults, is on the speakers’ bureau, and received grants from AbbVie/Allergan, Gilead, Intercept, and Perspectum. He consults and is on the speakers’ bureau for Echosens. He consults and received grants from Madrigal, Novo Nordisk, Pfizer, and Zydus. He consults for Fibronostics. He is on the speakers’ bureau for Alexion, Eisai, Exelixis, Salix, and Theratechnologies. He received grants from 89Bio, Akero, Arbutus, Better Therapeutics, Boehringer Ingelheim, Bristol Myers Squibb, Corcept, DSM, Galectin, Genentech, Genfit, Hepagene, Healio, Inventiva, Ionis, Merck, NGM, Noom, NorthSea, Poxel, and Viking. Quentin M. Anstee, on behalf of Newcastle University, consults and advises for Alimentiv, Akero, AstraZeneca, Axcella, 89Bio, Boehringer Ingelheim, Bristol Myers Squibb, Galmed, GENFIT, Genentech, Gilead, GlaxoSmithKline, Hanmi, HistoIndex, Intercept, Inventiva, Ionis, IQVIA, Janssen, Madrigal, Medpace, Merck, NGM Bio, Novartis, Novo Nordisk, PathAI, Pfizer, Prosciento, Poxel, Resolution Therapeutics, Ridgeline Therapeutics, Roche, RTI, Shionogi, and Terns. He is on the speakers’ bureau for Fishawack, Integritas Communications, Kenes, Novo Nordisk, Madrigal, Medscape, and Springer Healthcare. He received grants from AstraZeneca, Boehringer Ingelheim, and Intercept. He holds intellectual property rights with Elsevier, Ltd. He serves as coordinator of the IMI2 LITMUS consortium. Ramon Bataller is on the speakers’ bureau for AbbVie. Thomas Berg consults, advises, is on the speakers’ bureau, received grants, and employed by AbbVie, Gilead, and Intercept. He consults, is on the speakers’ bureau, and is employed by Janssen. He consults, is on the speakers’ bureau, and received grants from MSD/Merck, Novartis, Orphalan, and Sequana Medical. He consults and is on the speakers’ bureau for Alexion, Bayer, Eisai, Ipsen, SIRTEX, and SOBI. He consults and received grants from Humedics. He consults for Enyo Pharma, GlaxoSmithKline, HepaRegeniX GmbH, Roche, and Shionogi. He is on the speakers’ bureau for Advance Pharma, Falk Foundation, and MedUpdate GmbH. He received grants from Bristol Myers Squibb, Merz, and Norgine. Paul N. Brennan consults for Resolution Therapeutics. He is on the speakers’ bureau for Takeda. Patrizia Burra advises and is on the speakers’ bureau for Chiesi Farmaceutici and Gilead. She advises Astellas, Biotest, Kedrion, Novartis, and Sandoz. She is employed by Alpha Wasserman. Helena Cortez-Pinto consults, advises, and is on the speakers’ bureau for EISAI and Roche Portugal. She consults for Novo Nordisk and Orphalan. Kenneth Cusi consults and received grants from Novo Nordisk. He consults for Aligos, Allergan, Altimmune, Arrowhead, AstraZeneca, Bristol Myers Squibb, Boehringer Ingelheim, Coherus, Covance, Eli Lilly, Fractyl, Genentech, Gilead, Hanmi, Intercept, Janssen, Madrigal, Pfizer, Prosciento, Sagimet, and Siemens. He received grants from Cirius, Echosens, Inventiva, LabCorp, National Institute of Health, Nordic Bioscience, Novartis, Poxel, and Zydus. Nikos Dedes advises Gilead and GlaxoSmithKline. He has other interests with the Greek Patients Association and the Positive Voice (PLHIV Association). Ajay Duseja has other interests with the Indian National Association for the Study of the Liver (INASL). Sven M. Francque consults, is on the speakers’ bureau, and received grants from GENFIT, Gilead, Inventiva, and Merck Sharp & Dome. He consults and is on the speakers’ bureau for AbbVie, Allergan, Bayer, Eisai, Intercept, Novo Nordisk, and Promethera. He consults and received grants from Astellas, Janssen, and Roche. He consults for Actelion, Aelin Therapeutics, Aligos Therapeutics, AstraZeneca, Boehringer Ingelheim, Bristol-Meyers Squibb, Coherus, CSL Behring, Echosens, Enyo, Galapagos, Galmed, Genentech, Julius Clinical, Madrigal, Medimmune, NGM Bio, and Novartis. He is on the speakers’ bureau for Janssens Cilag. He received grants from Falk Pharma, GlympsBio, Pfizer, and Research Foundation Flanders. Amalia Gastaldelli consults, advises, is on the speakers’ bureau, received grants, and employed by Pfizer. She consults, is on the speakers’ bureau, received grants, and employed by Eli Lilly. She consults, advises, and is on the speakers’ bureau for Boehringer Ingelheim and Novo Nordisk. She consults for Fractyl and Merck Sharp & Dohme. She has other interests with the European NAFLD study group and European Group for Insulin Resistance (EGIR). Hannes Hagström consults and received grants from AstraZeneca. He received grants from EchoSens, Gilead, MSD, and Pfizer. He is employed by MediPlast. Aleksander Krag advises, received grants, and employed by Siemens. He received grants and holds patent rights from the Region of Southern Denmark and the University of Southern Denmark. He advises and is employed by Norgine and Nordic Bioscience. He advises Novo Nordisk. He received grants from AstraZeneca, the Danish National Research Foundation, Echosense, EU Horizon 20, Innovation Fund Denmark, and the Novo Nordisk Foundation. He is employed by Echosens. He holds intellectual property rights with Gyldendal. He has other interests with the European Association for the Study of The Liver (EASL). Philip N. Newsome consults, advises, is on the speakers’ bureau, received grants, and is employed by Novo Nordisk. He consults and advises Boehringer Ingelheim, Bristol Myers Squibb, Gilead, GlaxoSmithKline, Intercept, Madrigal, Pfizer, Poxel, and Sun Pharma. He is on the speakers’ bureau for AiCME. Mary E. Rinella consults for Amgen, CytoDyn, GlaxoSmithKline, HistoIndex, Intercept, Madrigal, NGM Bios, Novo Nordisk, Rivus, and Sonic Incytes. Diana Romero is on the speakers’ bureau for the European Association for the Study of The Liver (EASL). Marcelo Silva consults, advises, and received grants from Zydus. He received grants from AstraZeneca, GlaxoSmithKline, Inventiva, Merck, and MSK. He has other interests with ALEH and the Global NASH Council. C. Wendy Spearman is on the speakers’ bureau for Abbott. She is on the speakers’ bureau and is employed by Gilead. She has other interests with Society on Liver Disease of Africa and the International Advisory Board of The Lancet Gastroenterology and Hepatology Journal. Norah A. Terrault consults for Eiger BioPharmaceuticals, ENYO Pharma, Exigo, and Saol Therapeutics. She is on the speakers’ bureau for the Asian Pacific Association for the Study of the Liver (APASL), Canadian Association for the Study of the Liver (CASL), Duke University, European Association for the Study of the Liver (EASL), Gastroenterology Updates, IBD, Liver Disease (GUILD), Houston Methodist, International Liver Transplantation Society (ILTS), Pakistan Society for the Study of Liver Disease (PSSLD), and University of Alabama, Birmingham (UAB). She received grants from Durect Corp, Genentech-Roche, Gilead, GlaxoSmithKline, Helio Health, and the National Institutes of Health. She has other interests with the American Association for the Study of Liver Diseases (AASLD), Clinical Care Options (CCO), the Hepatitis B Foundation, HBV Forum, Indian National Association for the Study of the Liver (INASL), and Simply Speaking. Emmanuel A. Tsochatzis consults, advises, and is on the speakers’ bureau for Novo Nordisk. He consults and advises Boehringer Ingelheim and Pfizer. He is on the speakers’ bureau for Dr Falk. He has other interests with EASL Governing Board. Luca Valenti consults, advises, is on the speakers’ bureau, and received grants from Gilead. He consults and advises Boehringer Ingelheim, Intercept, Pfizer, Novo Nordisk. He consults for Astra Zeneca and Diatech Pharmacogenetics. He is on the speakers’ board for AbbVie, Alfa-Sigma, MSD, and Viatris. He holds intellectual property rights with Takeda. Marcela Villota-Rivas consults for the European Association for the Study of The Liver (EASL). Shira Zelber-Sagi is on the speakers’ board for AbbVie. Jörn M. Schattenberg consults, is on the speakers’ bureau, and is employed by Gilead. He consults, is on the speakers’ bureau, received grants from Boehringer Ingelheim. He consults and is on the speakers’ bureau for Madrigal and Novo Nordisk. He consults for Albireo Pharma, Apollo Endosurgery, Astra Zeneca, Bayer, Bristol Myers Squibb, GlaxoSmithKline, Intercept, Ipsen, Inventiva, MSD, Northsea Therapeutics, Novartis, Pfizer, Roche, Sanofi, and Siemens Healthineer. He is on the speakers’ bureau for Echosens, HistoIndex, and MedPublico GmbH. He received grants from, and Siemens Healthcare GmbH. He owns stock in AGED diagnostics and Hepta Bio. Vincent Wai-Sun Wong consults, is on the speakers’ bureau, received grants, and is employed by Gilead. He consults, is on the speakers’ bureau, and employed by AbbVie. He consults and is on the speakers’ bureau for Novo Nordisk. He consults for Boehringer Ingelheim, Echosens, Intercept, Inventiva, Pfizer, Sagimet, and TARGET PharmaSolutions. He is on the speakers’ bureau for Abbott and Unilab. He owns stock in Illuminatio Medical Technology Limited. Zobair M. Younossi consults for Abbott, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Cymabay, Gilead, GlaxoSmithKline, Intercept, Madrigal, Merck, Novo Nordisk, Quest, and Siemens. The remaining authors have no conflicts to report.
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