Endpoints and clinical trial design for nonalcoholic steatohepatitis

Nonalcoholic fatty liver disease is a common cause of chronic liver disease in the general population. Nonalcoholic steatohepatitis (NASH), the aggressive form of nonalcoholic fatty liver disease, is associated with an increased risk of liver-related mortality and cardiovascular disease. At present, a liver biopsy is the only generally acceptable method for the diagnosis of NASH and assessment of its progression toward cirrhosis. Although several treatments have shown evidence of efficacy in clinical trials of varying design, there are no approved treatments for NASH, and published trials are often too divergent to allow meaningful comparisons. There is thus a lack of established noninvasive, point-of-care diagnostics and approved treatment on one hand and a substantial population burden of disease on the other. These provide the rationale for developing consensus on key endpoints and clinical trial design for NASH. CONCLUSION: This article summarizes the consensus arrived at a meeting of the American Association for the Study of Liver Diseases on the key endpoints and specific trial design issues that are germane for development of diagnostic biomarkers and treatment trials for NASH. Copyright Copyright 2011 American Association for the Study of Liver Diseases.

Contributors

Sanyal, Arun J. Brunt, Elizabeth M. Kleiner, David E. Kowdley, Kris V. Chalasani, Naga Lavine, Joel E. Ratziu, Vlad McCullough, Arthur

Publication

Journal: Hepatology
Volume: 54
Issue: 1
Pages: 344 - 53
Year: 2011
DOI: 10.1002/hep.24376

Further Study Information

Current Stage: Not Applicable
Date:
Funding source(s): This work was supported by the American Association for the Study of Liver Diseases and represents the summary of the 2009 workshop on ‘‘Endpoints in Nonalcoholic Steatohepatitis’’ along with updated information where applicable. This work was also supported, in part, by the Intramural Research Program of the National Institutes of Health, National Cancer Institute.


Health Area

Disease Category: Endocrine & metabolic

Disease Name: Nonalcoholic steatohepatitis (NASH)

Target Population

Age Range: 0 - 100

Sex: Either

Nature of Intervention: Not specified

Stakeholders Involved

- Clinical experts
- Other (unknown)

Study Type

- COS for clinical trials or clinical research

Method(s)

- GRADE (Grading of Recommendations Assessment, Development, and Evaluation) scale

Semi structured discussion: workshop

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