S4-E11 - The Yin and Yang of Technology and Regulation

Send us Fan MailThe Surfers are joined by Jeff McIntyre of the Global Liver Institute for a thought-provoking impromptu session on what’s happening thus far for the Fatty Liver field in 2023. The panelists touch on topics which elicit responses ranging from positive excitement around scientific developments to head-scratching concern over public policy positions.06:31Jörn Schattenberg opens with comments on diagnostic and therapeutic advancements which follow the momentum gathered at an energizing NASH-TAG conference in January. He specifically points to the numerous abstracts (estimated at over 2500!) submitted that will contribute to a scientifically-stimulating EASL Congress held in Vienna this June. Jörn emphasizes that while drugs are leading the way, diagnostics are closely following and contributing to "excitement on both borders.” Louise Campbell adds her thoughts around the recent AASLD guidance and its focus on clarifying CAP scores for improved FibroScan assessment. Roger Green notes emerging competitor technologies, such as E-Scopics, and their influence on industry uptake of NITs.19:17Jeff expands on the trajectory of imminent drug approvals of obeticholic acid and resmetirom. He goes on to express mixed levels of enthusiasm around a draft report from ICER which includes pricing estimates for these drugs. The contention lies in the draft’s reference to NASH as a non-progressive disease - a position that the panelists clearly debunk. He next speculates on the future standard for noninvasive testing and biomarkers. His comments emphasize the “need for a noninvasive that can be scaled with the least amount of burden to primary care providers and the patient populations that need them.” Roger Green points to the various guidelines’ referral to FIB-4 as such a test.29:31Jeff introduces collaborative work by GLI which sets out to more formally “medicalize” obesity as a term considerate of genetic backgrounds and metabolic dynaminisms. He relates this discussion around nomenclature to that experienced in the Fatty Liver space. Conversation segues to the subject of nutrition and the often ominous landscape of public health policy.37:14Roger introduces a timely Lancet paper which coincided with Surfing NASH’s focus on pediatric and adolescent NAFLD and NASH. The US-based study suggests that in five randomly allocated centers from 2002 to 2018, annual increase in incidence of Type-2 diabetes among 10-19 year-olds was a staggering 5% per year. He connects the findings to the aforementioned ideas around public health policy and nutrition. As the session winds down, Roger invites the panelists to provide the most significant and optimistic thing they will be touching over the next three months followed by the greatest fear each has in the same space. Listen to the full feature to hear their responses and the rest of this well-balanced conversation.If you enjoy the episode, have questions or interest around its contents and Fatty Liver disease, we kindly ask that you submit reviews wherever you download our discussions. Alternatively, you can write to us directly at [email protected].