S4-E19.3 - The Role of Biopsy in Prescribing NASH Therapeutics

Send us Fan MailIn March 2023, Jeff McIntyre (GLI) introduced a draft report from the Institute for Clinical and Economic Review (ICER) on resmetirom and obeticholic acid for NASH. The Surfers dedicated an episode to expand on the contents, its shortcomings and potential implications with special guests Veronica Miller (Liver Forum) and Hannah Mamuszka (Alva10). In this conversation, SurfingNASHrevisits the topic after a public comments session took place last week. In doing so, patient advocates and friends of the podcast Mike Betel (Fatty Liver Alliance), Tony Villiotti (NASHkNOWledge) and Wayne Eskridge (Fatty Liver Foundation) join co-hosts Louise Campbell and Roger Green to share a range of impressions.Roger begins with the note that if the cost of biopsy is factored into the cost of diagnosing a patient, the cost of diagnosis will be absurd. The group goes on to more extensively explore the role of biopsy in prescribing NASH therapeutics. Wayne shares the idea that lifestyle adjustments take time and can be tremendously difficult to maintain. He asserts that because of this, it would be incredibly valuable if there were a therapeutic option that at least halted progression and in turn provides the time to successfully see through lifestyle interventions. Roger relates this perspective to how we consider trial endpoints. Louise adds comments around the recurring idea that while not every patient is symptomatic, we know this is a progressive disease which doesn’t necessarily fit the sort of spectrum described by ICER. Towards the end of the episode, Mike notes that the public comments session as a whole was rather liver-centric and siloed from more holistic metabolic thinking.If you enjoy the episode, have questions or interest around patient advocacy and Fatty Liver disease, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at [email protected] Safe and Surf On!