Author information
1HCD Economics Ltd., The Innovation Centre, Keckwick Lane, Daresbury, Cheshire WA4 4FS, United Kingdom.
2HCD Economics Ltd., The Innovation Centre, Keckwick Lane, Daresbury, Cheshire WA4 4FS, United Kingdom. Electronic address: bethany.franks@primeglobalpeople.com.
3Novo Nordisk A/S, Vandtårnsvej 108, 2860 Søborg, Denmark.
4UCM Digestive Diseases and CIBEREHD, 28029 Madrid, Spain; Virgen del Rocío University Hospital and Institute of Biomedicine of Seville (HUVR/CSIC/US), University of Seville, 41013 Seville, Spain.
5Metabolic Liver Research Program, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany.
Abstract
Objective: To better understand drivers of disease progression in non-alcoholic steatohepatitis (NASH), we assessed clinical and sociodemographic markers of fibrosis progression in adults with NASH.
Patients and methods: Physician-reported patient demographics and clinical characteristics were utilised from the real-world Global Assessment of the Impact of NASH (GAIN) study. Factors associated with likelihood of fibrosis progression since NASH diagnosis were identified using a logistic regression model.
Results: Overall, 2349 patients in Europe from the GAIN study were included; mean age was 54.6 years and 41% were women. Significant covariates included age, years since diagnosis, employment status, fibrosis stage at diagnosis, type 2 diabetes mellitus, hypertension, liver transplant and liver biopsy at diagnosis. Risk of progression was 1.16 (95% confidence interval 1.12-1.20; p<0.001) times higher for each additional year since NASH diagnosis and 5.43 (2.68-11.37; p<0.001) times higher when physicians proposed a liver transplant at diagnosis. Compared with full-time employed patients, risk of progression was 1.77 (1.19-2.60; p=0.004) times higher for unemployed patients and 3.16 (1.30-7.63; p=0.010) times higher for those unable to work due to NASH.
Conclusions: Disease duration, NASH severity and presence of other metabolic comorbidities could help to assess risk of progression in patients with NASH.