Lin, Huapeng and Lee, Hye Won and Yip, Terry Cheuk-Fung and Tsochatzis, Emmanuel and Petta, Salvatore and Bugianesi, Elisabetta and Yoneda, Masato and Zheng, Ming-Hua and Hagstrom, Hannes and Boursier, Jerome and Calleja, Jose Luis and Goh, George Boon-Bee and Chan, Wah Kheong and Gallego-Duran, Rocio and Sanyal, Arun J. and de Ledinghen, Victor and Newsome, Philip N. and Fan, Jian-Gao and Castera, Laurent and Lai, Michelle and Harrison, Stephen A. and Fournier-Poizat, Celine and Wong, Grace Lai-Hung and Pennisi, Grazia and Armandi, Angelo and Nakajima, Atsushi and Liu, Wen-Yue and Shang, Ying and de Saint-Loup, Marc and Llop, Elba and Teh, Kevin Kim-Jun and Lara-Romero, Carmen and Asgharpour, Amon and Mahgoub, Sara and Chan, Mandy Sau-Wai and Canivet, Clemence M. and Romero-Gomez, Manuel and Kim, Seung Up and Wong, Vincent Wai-Sun and Grp, VCTE Prognosis Study (2024) Vibration-Controlled Transient Elastography Scores to Predict Liver-Related Events in Steatotic Liver Disease. JAMA-Journal of the American Medical Association, 331 (15). pp. 1287-1297. ISSN 0098-7484, DOI https://doi.org/10.1001/jama.2024.1447.
Full text not available from this repository.Abstract
Importance Metabolic dysfunction-associated steatotic liver disease (MASLD) is currently the most common chronic liver disease worldwide. It is important to develop noninvasive tests to assess the disease severity and prognosis. Objective To study the prognostic implications of baseline levels and dynamic changes of the vibration-controlled transient elastography (VCTE)-based scores developed for the diagnosis of advanced fibrosis (Agile 3+) and cirrhosis (Agile 4) in patients with MASLD. Design, Setting, and Participants This cohort study included data from a natural history cohort of patients with MASLD who underwent VCTE examination at 16 tertiary referral centers in the US, Europe, and Asia from February 2004 to January 2023, of which the data were collected prospectively at 14 centers. Eligible patients were adults aged at least 18 years with hepatic steatosis diagnosed by histologic methods (steatosis in >= 5% of hepatocytes) or imaging studies (ultrasonography, computed tomography or magnetic resonance imaging, or controlled attenuation parameter >= 248 dB/m by VCTE). Main Outcomes and Measures The primary outcome was liver-related events (LREs), defined as hepatocellular carcinoma or hepatic decompensation (ascites, variceal hemorrhage, hepatic encephalopathy, or hepatorenal syndrome), liver transplant, and liver-related deaths. The Agile scores were compared with histologic and 8 other noninvasive tests. Results A total of 16 603 patients underwent VCTE examination at baseline (mean SD] age, 52.5 13.7] years; 9600 57.8%] were male). At a median follow-up of 51.7 (IQR, 25.2-85.2) months, 316 patients (1.9%) developed LREs. Both Agile 3+ and Agile 4 scores classified fewer patients between the low and high cutoffs than most fibrosis scores and achieved the highest discriminatory power in predicting LREs (integrated area under the time-dependent receiver-operating characteristic curve, 0.89). A total of 10 920 patients (65.8%) had repeated VCTE examination at a median interval of 15 (IQR, 11.3-27.7) months and were included in the serial analysis. A total of 81.9% of patients (7208 of 8810) had stable Agile 3+ scores and 92.6% of patients (8163 of 8810) had stable Agile 4 scores (same risk categories at both assessments). The incidence of LREs was 0.6 per 1000 person-years in patients with persistently low Agile 3+ scores and 30.1 per 1000 person-years in patients with persistently high Agile 3+ scores. In patients with high Agile 3+ score at baseline, a decrease in the score by more than 20% was associated with substantial reduction in the risk of LREs. A similar trend was observed for the Agile 4 score, although it missed more LREs in the low-risk group. Conclusions and Relevance Findings of this study suggest that single or serial Agile scores are highly accurate in predicting LREs in patients with MASLD, making them suitable alternatives to liver biopsy in routine clinical practice and in phase 2b and 3 clinical trials for steatohepatitis.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Hepatocellular-Carcinoma; Fibrosis stage; Cirrhosis; Time; Outcomes; Risk |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 08 Oct 2024 06:54 |
| Last Modified: | 08 Oct 2024 06:54 |
| URI: | http://eprints.um.edu.my/id/eprint/45308 |
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