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Preparing for the NASH epidemic: A call to action

      Abstract

      Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are common conditions with a rising burden. Yet there are significant management gaps between clinical guidelines and practice in patients with NAFLD and NASH. Further, there is no single global guiding strategy for the management of NAFLD and NASH. The American Gastroenterological Association, in collaboration with 7 professional associations, convened an international conference comprising 32 experts in gastroenterology, hepatology, endocrinology, and primary care providers from the United States, Europe, Asia, and Australia. Conference content was informed by the results of a national NASH Needs Assessment Survey. The participants reviewed and discussed published literature on global burden, screening, risk stratification, diagnosis, and management of individuals with NAFLD, including those with NASH. Participants identified promising approaches for clinical practice and prepared a comprehensive, unified strategy for primary care providers and relevant specialists encompassing the full spectrum of NAFLD/NASH care. They also identified specific high-yield targets for clinical research and called for a unified, international public health response to NAFLD and NASH.

      Keywords

      Abbreviations:

      AGA (American Gastroenterological Association;), ALT (alanine aminotransferase), AST (aspartate aminotransferase), CI (confidence interval), HCC (hepatocellular cancer), IHTG (intrahepatic triglyceride), NAFLD (nonalcoholic fatty liver disease), NASH (nonalcoholic steatohepatitis), PCP (primary care physician), RR (risk ratio), T2D (type 2 diabetes)
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