Preparing for the NASH epidemic: A call to action.

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.

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Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest These authors disclose the following: Jay H. Shubrook has served as an advisor to Sanofi, Eli Lilly, Novo Nordisk, Bayer, and MannKind. Elisabetta Bugianesi has served as a consultant to Gilead, BMS, Boehringer, Intercept, and Innova. Zobair Younossi has received research funding from or served as a consultant for Gilead Sciences, Intercept, BMS, Novo Nordisk, Viking, Terns, Siemens, Shionogi, AbbVie, Madrigal, Merck, Abbott, Axcella, and Novartis. Yamini Natarajan has received grants from Gilead and Allergan. Mary E. Rinella has served as a consultant for Amgen, Alnylam, Allergan, BMS, Boehringer Ingelheim, Coherus, CymaBay, Enanta, Fibrogen, Fractyl, Galecto, Gelesis, Genentech, GENFIT, Gilead, Intercept, Lipocine, Madrigal, Merck, Metacrine, NGM Biopharmaceuticals, Novo Nordisk, Novartis, Pfizer, Sagimet, Siemens, Takeda, Terns, Thetis, Viking, 3vBio, 89Bio. Robert H. Eckel has served on advisory boards for Novo Nordisk, Provention Bio, Kaleido, and KOWA, and a scientific advisory committee for PROMINENT (CVOT). Stephen A. Harrison has served as advisory board/consultant for Akero, Altimmune, Arrowhead, Axcella, B. Riley, Boston Pharma, Cirius, Civi Biotherma, CLDF, Corcept, CymaBay, Echosens, Fibronostics, Foresite Labs, Fortress, Galectin, Gelesis, GENFIT, Gilead, Hepion, Hightide Bio, HistoIndex, Intercept, Inipharm, Ionis, Kowa, Madrigal, Medpace, Metacrine, Microba, NGM Bio, NorthSea, Novartis, Novo Nordisk, Piper Sandler, Poxel, Prometic, Ridgeline Therapeutics, Sagiment, Sonic Incytes, Terns, Theratech, Viking, 89 Bio; received grant/research support from Axcella, BMS, Cirius, Civi Biopharma, Conatus, CymaBay, Enyo, Galectin, Galmed, Genentech, GENFIT, Gilead, Hepion, Hightide Bio, Immuron, Intercept, Madrigal, NGM Bio, NorthSea, Novartis, Novo Nordisk, Pfizer, Sagimet, Second Genome, Tobira/Allergan, Viking; and has stock/shares (self-managed) in Akero, Cirius, Galectin, GENFIT, Hepion, HistoIndex, Metacrine, NGM Bio, and NorthSea. Christos Mantzoros reports grants, personal fees, and other from Coherus Biosciences, grants, personal fees and other from Novo Nordisk, personal fees and nonfinancial support from Ansh, Aegerion, PES, California Walnut Commission, and personal fees from GENFIT, Intercept, Regeneron, CardioMetabolic Health Conference and The Metabolic Institute of America, and Amgen. Samuel Klein is a shareholder of Aspire Bariatrics and has served as a consultant for Pfizer, Novo Nordisk, and Boehringer Ingelheim. Robert H. Eckel has received research funding from Gilead (2014–2015), Merck (2016–2018), and Wako (2014–2017). Kenneth Cusi has received research support as principal investigator for the University of Florida from Cirius, Echosens, Inventiva, Novartis, Novo Nordisk, Poxel, and Zydus, and is a consultant for Allergan, Astra-Zeneca, Axcella, BMS, Boehringer Ingelheim, Coherus, Eli Lilly, Genentech, Gilead, HighTide, Inventiva, Intercept, Ionis, Janssen, Pfizer, Poxel, Prosciento, Madrigal, Novo Nordisk, and Sanofi-Aventis. The remaining authors disclose no conflicts.