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},
{
"groupId": "FG001",
"numSubjects": "61"
},
{
"groupId": "FG002",
"numSubjects": "69"
}
]
},
{
"type": "NOT COMPLETED",
"achievements": [
{
"groupId": "FG000",
"numSubjects": "6"
},
{
"groupId": "FG001",
"numSubjects": "8"
},
{
"groupId": "FG002",
"numSubjects": "5"
}
]
}
],
"dropWithdraws": [
{
"type": "Lost to Follow-up",
"reasons": [
{
"groupId": "FG000",
"numSubjects": "1"
},
{
"groupId": "FG001",
"numSubjects": "1"
},
{
"groupId": "FG002",
"numSubjects": "0"
}
]
},
{
"type": "Withdrawal by Subject",
"reasons": [
{
"groupId": "FG000",
"numSubjects": "5"
},
{
"groupId": "FG001",
"numSubjects": "6"
},
{
"groupId": "FG002",
"numSubjects": "5"
}
]
},
{
"type": "SAE",
"reasons": [
{
"groupId": "FG000",
"numSubjects": "0"
},
{
"groupId": "FG001",
"numSubjects": "1"
},
{
"groupId": "FG002",
"numSubjects": "0"
}
]
}
]
}
]
},
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"outcomeMeasures": [
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"type": "PRIMARY",
"title": "Proportion of Participants Achieving NASH Resolution Without Worsening of Fibrosis Based on Histology After 52 Weeks of Treatment",
"description": "To assess the effect of AZD2693 versus placebo on histological resolution of NASH in participants with non-cirrhotic NASH with fibrosis and PNPLA3 risk allele carriers after 52 weeks of treatment",
"reportingStatus": "POSTED",
"paramType": "COUNT_OF_PARTICIPANTS",
"unitOfMeasure": "Participants",
"timeFrame": "From baseline to week 54",
"groups": [
{
"id": "OG000",
"title": "AZD2693 25 mg",
"description": "Participants in this arm will receive AZD2693 25 mg"
},
{
"id": "OG001",
"title": "AZD2693 50 mg",
"description": "Participants in this arm will receive AZD2693 50 mg"
},
{
"id": "OG002",
"title": "Placebo",
"description": "Participants in this arm will receive placebo"
}
],
"denoms": [
{
"units": "Participants",
"counts": [
{
"groupId": "OG000",
"value": "73"
},
{
"groupId": "OG001",
"value": "69"
},
{
"groupId": "OG002",
"value": "74"
}
]
}
],
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{
"categories": [
{
"measurements": [
{
"groupId": "OG000",
"value": "4"
},
{
"groupId": "OG001",
"value": "1"
},
{
"groupId": "OG002",
"value": "5"
}
]
}
]
}
],
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{
"groupIds": [
"OG000",
"OG002"
],
"nonInferiorityType": "SUPERIORITY",
"pValue": "0.783",
"statisticalMethod": "Cochran-Mantel-Haenszel",
"paramType": "Odds Ratio (OR)",
"paramValue": "0.83",
"ciPctValue": "95",
"ciNumSides": "TWO_SIDED",
"ciLowerLimit": "0.21",
"ciUpperLimit": "3.23",
"estimateComment": "An odds ratio greater than 1 favours AZD2693 dose group."
},
{
"groupIds": [
"OG001",
"OG002"
],
"nonInferiorityType": "SUPERIORITY",
"pValue": "0.116",
"statisticalMethod": "Cochran-Mantel-Haenszel",
"paramType": "Odds Ratio (OR)",
"paramValue": "0.20",
"ciPctValue": "95",
"ciNumSides": "TWO_SIDED",
"ciLowerLimit": "0.02",
"ciUpperLimit": "1.78",
"estimateComment": "An odds ratio greater than 1 favours AZD2693 dose group."
}
]
},
{
"type": "SECONDARY",
"title": "Proportion of Participants With at Least One Stage of Liver Fibrosis Improvement With no Worsening of NASH Based on Biopsy After 52 Weeks of Treatment",
"description": "To assess the effects of AZD2693 versus placebo on histological fibrosis improvement",
"reportingStatus": "POSTED",
"paramType": "COUNT_OF_PARTICIPANTS",
"unitOfMeasure": "Participants",
"timeFrame": "From baseline to week 54",
"groups": [
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"id": "OG000",
"title": "AZD2693 25 mg",
"description": "Participants in this arm will receive AZD2693 25 mg"
},
{
"id": "OG001",
"title": "AZD2693 50 mg",
"description": "Participants in this arm will receive AZD2693 50 mg"
},
{
"id": "OG002",
"title": "Placebo",
"description": "Participants in this arm will receive placebo"
}
],
"denoms": [
{
"units": "Participants",
"counts": [
{
"groupId": "OG000",
"value": "73"
},
{
"groupId": "OG001",
"value": "69"
},
{
"groupId": "OG002",
"value": "74"
}
]
}
],
"classes": [
{
"categories": [
{
"measurements": [
{
"groupId": "OG000",
"value": "12"
},
{
"groupId": "OG001",
"value": "6"
},
{
"groupId": "OG002",
"value": "8"
}
]
}
]
}
],
"analyses": [
{
"groupIds": [
"OG000",
"OG002"
],
"nonInferiorityType": "SUPERIORITY",
"pValue": "0.320",
"statisticalMethod": "Cochran-Mantel-Haenszel",
"paramType": "Odds Ratio (OR)",
"paramValue": "1.64",
"ciPctValue": "95",
"ciNumSides": "TWO_SIDED",
"ciLowerLimit": "0.62",
"ciUpperLimit": "4.37",
"estimateComment": "An odds ratio greater than 1 favours AZD2693 dose group."
},
{
"groupIds": [
"OG001",
"OG002"
],
"nonInferiorityType": "SUPERIORITY",
"pValue": "0.693",
"statisticalMethod": "Cochran-Mantel-Haenszel",
"paramType": "Odds Ratio (OR)",
"paramValue": "0.80",
"ciPctValue": "95",
"ciNumSides": "TWO_SIDED",
"ciLowerLimit": "0.26",
"ciUpperLimit": "2.44",
"estimateComment": "An odds ratio greater than 1 favours AZD2693 dose group."
}
]
},
{
"type": "SECONDARY",
"title": "Proportion of Participants With ≥ 2-point Improvement From Baseline in NAS Based on Biopsy After 52 Weeks of Treatment",
"description": "To assess the effect of AZD2693 versus placebo on ≥ 2-point improvement in NAS",
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"paramType": "COUNT_OF_PARTICIPANTS",
"unitOfMeasure": "Participants",
"timeFrame": "From baseline to week 54",
"groups": [
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"id": "OG000",
"title": "AZD2693 25 mg",
"description": "Participants in this arm will receive AZD2693 25 mg"
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{
"id": "OG001",
"title": "AZD2693 50 mg",
"description": "Participants in this arm will receive AZD2693 50 mg"
},
{
"id": "OG002",
"title": "Placebo",
"description": "Participants in this arm will receive placebo"
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],
"denoms": [
{
"units": "Participants",
"counts": [
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"groupId": "OG000",
"value": "73"
},
{
"groupId": "OG001",
"value": "69"
},
{
"groupId": "OG002",
"value": "74"
}
]
}
],
"classes": [
{
"categories": [
{
"measurements": [
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"groupId": "OG000",
"value": "22"
},
{
"groupId": "OG001",
"value": "12"
},
{
"groupId": "OG002",
"value": "23"
}
]
}
]
}
],
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{
"groupIds": [
"OG000",
"OG002"
],
"nonInferiorityType": "SUPERIORITY",
"pValue": "0.885",
"statisticalMethod": "Cochran-Mantel-Haenszel",
"paramType": "Odds Ratio (OR)",
"paramValue": "0.95",
"ciPctValue": "95",
"ciNumSides": "TWO_SIDED",
"ciLowerLimit": "0.47",
"ciUpperLimit": "1.92",
"estimateComment": "An odds ratio greater than 1 favours AZD2693 dose group."
},
{
"groupIds": [
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"OG002"
],
"nonInferiorityType": "SUPERIORITY",
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"paramType": "Odds Ratio (OR)",
"paramValue": "0.45",
"ciPctValue": "95",
"ciNumSides": "TWO_SIDED",
"ciLowerLimit": "0.20",
"ciUpperLimit": "1.01",
"estimateComment": "An odds ratio greater than 1 favours AZD2693 dose group."
}
]
},
{
"type": "SECONDARY",
"title": "Proportion of Participants With Improvement in Fibrosis by at Least One Stage Based on Biopsy After 52 Weeks of Treatment",
"description": "To assess the effect of AZD2693 versus placebo on improvement in fibrosis by at least one stage",
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"paramType": "COUNT_OF_PARTICIPANTS",
"unitOfMeasure": "Participants",
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"id": "OG000",
"title": "AZD2693 25 mg",
"description": "Participants in this arm will receive AZD2693 25 mg"
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{
"id": "OG001",
"title": "AZD2693 50 mg",
"description": "Participants in this arm will receive AZD2693 50 mg"
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{
"id": "OG002",
"title": "Placebo",
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"units": "Participants",
"counts": [
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"groupId": "OG000",
"value": "73"
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{
"groupId": "OG001",
"value": "69"
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{
"groupId": "OG002",
"value": "74"
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]
}
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"classes": [
{
"categories": [
{
"measurements": [
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"groupId": "OG000",
"value": "14"
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{
"groupId": "OG001",
"value": "7"
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{
"groupId": "OG002",
"value": "10"
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}
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}
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{
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"OG002"
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"ciUpperLimit": "3.80",
"estimateComment": "An odds ratio greater than 1 favours AZD2693 dose group."
},
{
"groupIds": [
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"OG002"
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"nonInferiorityType": "SUPERIORITY",
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"paramValue": "0.73",
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"ciNumSides": "TWO_SIDED",
"ciLowerLimit": "0.26",
"ciUpperLimit": "2.03",
"estimateComment": "An odds ratio greater than 1 favours AZD2693 dose group."
}
]
},
{
"type": "OTHER_PRE_SPECIFIED",
"title": "Number of Participants With Abnormal Laboratory Test Results",
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"reportingStatus": "POSTED",
"paramType": "COUNT_OF_PARTICIPANTS",
"unitOfMeasure": "Participants",
"timeFrame": "Baseline to 64 weeks",
"groups": [
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"id": "OG000",
"title": "AZD2693 25 mg",
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{
"id": "OG001",
"title": "AZD2693 50 mg",
"description": "Participants in this arm will receive AZD2693 50 mg"
},
{
"id": "OG002",
"title": "Placebo",
"description": "Participants in this arm will receive placebo"
}
],
"denoms": [
{
"units": "Participants",
"counts": [
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"groupId": "OG000",
"value": "73"
},
{
"groupId": "OG001",
"value": "69"
},
{
"groupId": "OG002",
"value": "74"
}
]
}
],
"classes": [
{
"title": "ALT > 3ULN",
"categories": [
{
"measurements": [
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"groupId": "OG000",
"value": "18"
},
{
"groupId": "OG001",
"value": "33"
},
{
"groupId": "OG002",
"value": "10"
}
]
}
]
},
{
"title": "ALP > 3ULN",
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{
"measurements": [
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"value": "1"
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{
"groupId": "OG001",
"value": "0"
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{
"groupId": "OG002",
"value": "0"
}
]
}
]
},
{
"title": "AST > 3ULN",
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{
"measurements": [
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"groupId": "OG000",
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{
"groupId": "OG001",
"value": "18"
},
{
"groupId": "OG002",
"value": "11"
}
]
}
]
},
{
"title": "direct Bilirubin > ULN",
"categories": [
{
"measurements": [
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"groupId": "OG000",
"value": "5"
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{
"groupId": "OG001",
"value": "7"
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{
"groupId": "OG002",
"value": "4"
}
]
}
]
},
{
"title": "Creatinine > ULN",
"categories": [
{
"measurements": [
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"groupId": "OG000",
"value": "1"
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{
"groupId": "OG001",
"value": "2"
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{
"groupId": "OG002",
"value": "7"
}
]
}
]
},
{
"title": "B-platelet count > ULN",
"categories": [
{
"measurements": [
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"groupId": "OG000",
"value": "9"
},
{
"groupId": "OG001",
"value": "5"
},
{
"groupId": "OG002",
"value": "9"
}
]
}
]
},
{
"title": "Blood >= ++",
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{
"measurements": [
{
"groupId": "OG000",
"value": "6"
},
{
"groupId": "OG001",
"value": "14"
},
{
"groupId": "OG002",
"value": "7"
}
]
}
]
},
{
"title": "Glucose >= ++",
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{
"measurements": [
{
"groupId": "OG000",
"value": "13"
},
{
"groupId": "OG001",
"value": "24"
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{
"groupId": "OG002",
"value": "29"
}
]
}
]
},
{
"title": "Protein >= ++",
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{
"measurements": [
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"groupId": "OG000",
"value": "6"
},
{
"groupId": "OG001",
"value": "4"
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{
"groupId": "OG002",
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}
]
}
]
},
{
"title": "eGFR > 25% decrease",
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{
"measurements": [
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{
"groupId": "OG001",
"value": "3"
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{
"groupId": "OG002",
"value": "10"
}
]
}
]
}
]
},
{
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{
"id": "OG001",
"title": "AZD2693 50 mg",
"description": "Participants in this arm will receive AZD2693 50 mg"
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{
"id": "OG002",
"title": "Placebo",
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],
"denoms": [
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"units": "Participants",
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{
"groupId": "OG001",
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{
"groupId": "OG002",
"value": "74"
}
]
}
],
"classes": [
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"groupId": "OG000",
"value": "15"
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{
"groupId": "OG001",
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{
"groupId": "OG002",
"value": "25"
}
]
}
]
},
{
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"measurements": [
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{
"groupId": "OG001",
"value": "30"
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{
"groupId": "OG002",
"value": "28"
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]
}
]
},
{
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{
"groupId": "OG001",
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]
}
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},
{
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{
"groupId": "OG001",
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{
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]
}
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},
{
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{
"groupId": "OG001",
"value": "1"
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{
"groupId": "OG002",
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]
}
]
}
]
}
]
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"deathsNumAtRisk": 73,
"seriousNumAffected": 7,
"seriousNumAtRisk": 73,
"otherNumAffected": 49,
"otherNumAtRisk": 73
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{
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"deathsNumAtRisk": 69,
"seriousNumAffected": 3,
"seriousNumAtRisk": 69,
"otherNumAffected": 49,
"otherNumAtRisk": 69
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{
"id": "EG002",
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"deathsNumAtRisk": 74,
"seriousNumAffected": 7,
"seriousNumAtRisk": 74,
"otherNumAffected": 53,
"otherNumAtRisk": 74
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"crossref_retraction_flag": false
},
{
"pmid": "42929711",
"doi": "10.1097/HEP.0000000000001886",
"pubmed_publication_types": [
"Journal Article"
],
"pubmed_corrections": [],
"pubmed_retraction_flag": false,
"crossref_updated_by": [],
"crossref_retraction_flag": false
},
{
"pmid": "42935238",
"doi": "10.3350/cmh.2026.1023",
"pubmed_publication_types": [
"Journal Article"
],
"pubmed_corrections": [],
"pubmed_retraction_flag": false,
"crossref_updated_by": [],
"crossref_retraction_flag": false
},
{
"pmid": "42956772",
"doi": "10.1016/S0140-6736(26)01145-1",
"pubmed_publication_types": [
"Journal Article",
"Multicenter Study",
"Observational Study"
],
"pubmed_corrections": [],
"pubmed_retraction_flag": false,
"crossref_updated_by": [],
"crossref_retraction_flag": false
}
],
"added_record_metadata": {
"42624290": {
"pmid": "42624290",
"title": "Baveno VIII - Advancing consensus in portal hypertension.",
"abstract": "Since the first Baveno Consensus Conference in 1990, successive conferences held every 5 years have transformed the field of cirrhosis and portal hypertension, evolving from a focus on variceal bleeding to a pathophysiology-based framework centred on risk stratification, clinically significant portal hypertension (CSPH), and the prevention of decompensation. Building on this progress, the Baveno Cooperation, in collaboration with the Vascular Liver Disease Interest Group (VALDIG), convened an expert faculty to review the evidence published since Baveno VII and update clinical guidance for patients with advanced chronic liver disease (ACLD), portal hypertension, and vascular liver diseases. The Baveno VIII Consensus Conference, held in March 2026 in Baveno, Italy, was based on a structured consensus process across nine panels addressing key domains of ACLD, portal hypertension, and vascular liver diseases. Statements and recommendations were developed through iterative review of the evidence and voting among faculty, with strong consensus defined as >80% faculty agreement. A total of 272 statements and recommendations achieved strong consensus. Key areas included non-invasive risk stratification in compensated ACLD (cACLD), modifiers of steatotic liver disease, prevention of first and further decompensation, management of portal hypertensive bleeding and further decompensation, cirrhosis recompensation, and vascular liver diseases, including Budd-Chiari syndrome, portosinusoidal vascular disorder (PSVD) or non-cirrhotic portal fibrosis (NCPF), and portal vein thrombosis (PVT). The central role of CSPH and the expanding use of non-invasive tests were reaffirmed, and several diagnostic and prognostic cut-offs were revised. New to Baveno VIII is the inclusion of selected guidance for paediatric patients. Recommendations from previous conferences that were not specifically revised in Baveno VIII, such as those on hepatic venous pressure gradient (HVPG) measurement, remain valid. Finally, a research agenda identifying 153 priority topics is proposed.",
"authors": [
""
],
"journal": "J Hepatol",
"volume": "85",
"issue": "5",
"pages": "993-1018",
"date": "2026Nov",
"publication_types": [
"Consensus Statement",
"Journal Article"
],
"ids": {
"pubmed": "42624290",
"doi": "10.1016/j.jhep.2026.07.030",
"pii": "S0168-8278(26)02778-9"
},
"corrections": []
},
"42648297": {
"pmid": "42648297",
"title": "ALG-055009 in non-cirrhotic adults with metabolic dysfunction-associated steatohepatitis (HERALD): a randomised, double-blind, placebo-controlled, phase 2a trial.",
"abstract": "Thyroid hormone receptor β (THR-β) agonists reduce atherogenic lipids, hepatic fat, and improve histology in metabolic dysfunction-associated steatohepatitis (MASH). The phase 2a HERALD study evaluated the efficacy, safety, pharmacokinetics, and pharmacodynamics of the selective and potent THR-β agonist ALG-055009 in non-cirrhotic adult patients with presumed MASH.\nIn this double-blind, placebo-controlled, phase 2a trial, participants aged 18-75 years with a BMI of at least 25 kg/m2 and a diagnosis of presumed non-alcoholic steatohepatitis (NASH) or MASH with F1-F3 liver fibrosis were randomly assigned to receive oral ALG-055009 (0·3 mg, 0·5 mg, 0·7 mg, or 0·9 mg) or placebo once daily for 12 weeks. Enrolment in the 0·9 mg group was limited to participants with bodyweight of more than 85 kg. The primary endpoint was percentage relative change from baseline in liver fat by MRI-proton density fat fraction (MRI-PDFF) at week 12 in the MRI-PDFF analysis population. The trial is registered at ClinicalTrials.gov, NCT06342947, and is now completed.\n102 participants (39 [38%] males and 63 [62%] females) were randomly assigned to receive ALG-055009 0·3 mg (n=20), ALG-055009 0·5 mg (n=22), ALG-055009 0·7 mg (n=20), ALG-055009 0·9 mg (n=18), or placebo (n=22); five participants (two in the 0·3 mg group, one in the 0·5 mg group, one in the 0·9 mg group, and one in the placebo group) did not have baseline and week 12 MRI-PDFF data and were thus not included in the analysis of the primary endpoint. Least-squares mean relative change in liver fat at week 12 was -6·9% (95% CI -19·2 to 5·3) with 0·3 mg ALG-055009, -11·2% (-22·9 to 0·4) with 0·5 mg ALG-055009, -25·9% (-37·7 to -14·1) with 0·7 mg ALG-055009, -24·3% (-37·9 to -10·6) with 0·9 mg ALG-055009, and 7·3% (-4·0 to 18·6) with placebo. Placebo-adjusted least-squares mean relative changes in liver fat at week 12 were therefore -14·3% (95% CI -29·6 to 1·0; p=0·067) for 0·3 mg ALG-055009, -18·5% (-33·3 to -3·8; p=0·014) for 0·5 mg ALG-055009, -33·2% (-48·1 to -18·3; p<0·0001) for 0·7 mg ALG-055009, and -31·6% (-47·4 to -15·8; p=0·0001) for 0·9 mg ALG-055009. Treatment-emergent adverse events occurred in 13 (65%) participants receiving 0·3 mg ALG-055009, ten (45%) receiving 0·5 mg ALG-055009, 13 (65%) receiving 0·7 mg ALG-055009, 11 (61%) receiving 0·9 mg ALG-055009, and in 16 (73%) receiving placebo. Most treatment-emergent adverse events were mild or moderate, with the most common being diarrhoea (ten [10%]), fatigue (six [6%]), and constipation (five [5%]). One serious adverse event occurred in the placebo group, and no deaths occurred. Gastrointestinal treatment-emergent adverse event rates for ALG-055009 were similar to placebo, and no clinically meaningful changes in laboratory tests, electrocardiogram, vital signs, physical exams, or thyroid function were observed.\nStatistically significant reductions in liver fat with ALG-055009 and no relevant safety issues suggest that ALG-055009 could offer a promising treatment approach for patients with MASH. Results support evaluating extended ALG-055009 dosing on liver histology in participants with MASH.\nAligos Therapeutics.",
"authors": [
"Loomba R",
"Wang S",
"Desai D",
"Santillano D",
"Lucas KJ",
"Neff G",
"Bianco AC",
"Bruinstroop E",
"Su Y",
"Achneck HE",
"Le K",
"Fitzgerald M",
"Wu M",
"Lin TI",
"Chanda SM",
"Blatt LM",
"Mantzoros CS"
],
"journal": "Lancet Gastroenterol Hepatol",
"volume": "11",
"issue": "11",
"pages": "984-996",
"date": "2026Nov",
"publication_types": [
"Journal Article",
"Randomized Controlled Trial",
"Clinical Trial, Phase II",
"Multicenter Study"
],
"ids": {
"pubmed": "42648297",
"doi": "10.1016/S2468-1253(26)00154-8",
"pii": "S2468-1253(26)00154-8"
},
"corrections": []
},
"42805503": {
"pmid": "42805503",
"title": "EASL-EASD-EASO guidance on the use of resmetirom and semaglutide as MASH-targeted therapy.",
"abstract": "Adults with metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH) are at risk of cardiometabolic complications and major adverse liver-related outcome (MALO), including cirrhosis, cancer, and liver transplantation. Non-invasive tests (NITs) for hepatic fibrosis, including vibration-controlled transient elastography (VCTE), magnetic resonance elastography (MRE), or enhanced liver fibrosis (ELF) score, can replace liver biopsy to identify patients at high risk of MALOs (e.g. VCTE 10-20 kPa, MRE 3.1-5.0 kPa, or ELF 9.8-11.3), in which pharmacotherapy may be considered. Following approval by regulatory agencies, this joint EASL-EASD-EASO guidance provides updated recommendations for the use of resmetirom (80 mg/100 mg per os) and semaglutide (2.4 mg subcutaneously weekly) in MASH, covering treatment candidate selection, treatment initiation, monitoring, and discontinuation. Pharmacotherapy is recommended for adults with non-cirrhotic MASH and fibrosis stages 2-3 (based on NITs or biopsy), alongside structured lifestyle intervention and optimised comorbidity management. Treatment selection should be individualised according to preferences, potential risks, and cardio-renal-metabolic profile, including presence of obesity, type 2 diabetes (T2D), cardiovascular, and chronic kidney disease. Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), may be preferred in adults with obesity or T2D as well as with established cardiovascular disease or high cardiovascular risk because of its cardiometabolic benefits, whereas resmetirom may be prioritised in individuals without obesity or those already receiving or intolerant to GLP-1RAs. Additional recommendations include structured safety and efficacy monitoring such as nutritional and sarcopenia assessment during semaglutide or use of fibrosis NITs for longitudinal response criteria. Ongoing studies are evaluating the long-term effectiveness of both agents to reduce MALOs. In adults with MASH cirrhosis, resmetirom or semaglutide appear safe but should not be used as MASH-targeted treatment, until further data establish liver-related benefits.",
"authors": [
"European Association for the Study of the Liver (EASL)",
"European Association for the Study of Diabetes (EASD)",
"European Association for the Study of Obesity (EASO). Electronic address: easloffice@easloffice.eu",
"European Association for the Study of Obesity (EASO)"
],
"journal": "J Hepatol",
"volume": null,
"issue": null,
"pages": null,
"publication_types": [
"Journal Article",
"Practice Guideline"
],
"ids": {
"pubmed": "42805503",
"doi": "10.1016/j.jhep.2026.08.028",
"pii": "S0168-8278(26)02877-1"
},
"corrections": []
},
"42922180": {
"pmid": "42922180",
"title": "Taiwan GEST-TASL-TMASO Joint Position Statement in Managing Metabolic Dysfunction-Associated Steatotic Liver Disease and Obesity.",
"abstract": "Metabolic dysfunction-associated steatotic liver disease (MASLD) and obesity share common pathogenesis and are increasingly relevant in clinical care. This joint statement addresses the need for comprehensive guidance in Taiwan for MASLD patients with obesity. The Gastroenterological Society of Taiwan, the Taiwan Association for the Study of the Liver, and the Taiwan Medical Association for the Study of Obesity conducted an evidence-based review, integrating epidemiological data, clinical trial outcomes, and expert consensus to develop position statements covering diagnosis, disease burden, pathogenesis, surveillance, and therapeutic strategies. MASLD prevalence in Taiwanese adults is 30%-45%, reaching 60%-70% in individuals with obesity, with similar high prevalence in children and adolescents. Obesity accelerates hepatic and extrahepatic disease progression, including cirrhosis, hepatocellular carcinoma, and cardiovascular complications. Lifestyle interventions, glucagon-like peptide-1 receptor agonists, resmetirom, and bariatric surgery demonstrate efficacy in improving hepatic and metabolic outcomes. Risk stratification using noninvasive tools such as Fibrosis-4 and vibration-controlled transient elastography effectively guides referral and management. A multidisciplinary, precision-based approach, integrating lifestyle modification, pharmacotherapy, surgical options, and risk stratification, is essential for effective MASLD management in patients with obesity, while research into artificial intelligence-driven biomarkers, gut microbiota modulation, and genetic factors represents future directions.",
"authors": [
"Cheng PN",
"Lu CW",
"Lin CL",
"Chiang CH",
"Yang HI",
"Kao HH",
"Wang CC",
"Chou TJ",
"Chang ML",
"Hsiao TJ",
"Peng CY",
"Huang JF",
"Chen TP",
"Dai CY",
"Yu ML",
"Huang KC",
"Kao JH",
"Lin WY",
"Liu CJ"
],
"journal": "Liver Int",
"volume": "46",
"issue": "11",
"pages": null,
"date": "2026Nov",
"publication_types": [
"Journal Article",
"Consensus Statement",
"Review"
],
"ids": {
"pubmed": "42922180",
"doi": "10.1111/liv.70926",
"pii": "e70926"
},
"corrections": []
},
"42929259": {
"pmid": "42929259",
"title": "The Madrid Declaration on metabolic dysfunction-associated steatotic liver disease (MASLD). Innovation, equity, and transformation of the health-system response to the metabolic disease challenge of the 21st century.",
"abstract": "Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide and one of the most clinically important manifestations of systemic metabolic dysfunction. Rather than a condition confined to the liver, MASLD represents an early marker of risk within the cardio-hepato-renal-metabolic continuum and an opportunity to intervene before irreversible organ damage becomes established. The Madrid Declaration on MASLD emerged from the meeting 'Innovation and Equity in the Management of MASLD', held on 4 March 2026 at the headquarters of the Spanish General Medical Council, with the endorsement of the Council and several scientific societies. In line with resolution WHA79.4, adopted by the Seventy-ninth World Health Assembly in May 2026, the Declaration sets out a ten-point framework for a health-system and policy response commensurate with the scale of the challenge. It calls for MASLD to be recognised as a public health priority and explicitly integrated into national strategies for noncommunicable diseases. Key proposals include early detection and risk stratification using non-invasive tools in primary care, supported by stepwise referral pathways that ensure an effective clinical response after detection. The Declaration further advocates value-based care and risk-proportionate interventions, reserving specialist care for people at greatest risk of progression and currently authorised disease-specific pharmacotherapies for appropriately selected patients with non-cirrhotic MASH and F2-F3 fibrosis. Equity is positioned as a structural principle of care, alongside stigma-free communication, integrated multidisciplinary models of care, and transparent evaluation against verifiable targets. The Declaration calls on policymakers, institutions, scientific societies, health professionals, and civil society to act in a coordinated and evidence-based manner.",
"authors": [
"Crespo J",
"Bañares R",
"Calleja JL",
"Carretero Gómez J",
"Castillo T",
"Cobo Castro T",
"Escalada J",
"Fernández Rodríguez CM",
"Fontanillas N",
"Iruzubieta P",
"Lazarus J",
"Martínez-Chantar ML",
"Romero Gómez M",
"Tinahones F",
"de Vega T"
],
"journal": "Rev Esp Enferm Dig",
"volume": null,
"issue": null,
"pages": null,
"date": "2026Oct26",
"publication_types": [
"Journal Article"
],
"ids": {
"pubmed": "42929259",
"doi": "10.17235/reed.2026.12198/2026"
},
"corrections": []
},
"42956772": {
"pmid": "42956772",
"title": "Non-invasive tests in metabolic dysfunction-associated steatotic liver disease: the LITMUS prospective multicentre diagnostic accuracy study.",
"abstract": "The advent of regulatory-approved pharmacological treatments for metabolic dysfunction-associated steatotic liver disease (MASLD) calls for precise, non-invasive biomarkers that facilitate early diagnosis, support therapy selection, and aid clinical trial enrolment. The European multicentre LITMUS study aimed to evaluate the diagnostic performance of a broad range of non-invasive biomarkers for identifying patients with metabolic dysfunction-associated steatohepatitis (MASH), at-risk MASH, advanced fibrosis, and cirrhosis.\nIn this prospective, multicentre, diagnostic accuracy study, adults with biopsy-confirmed MASLD were prospectively recruited across 13 countries in Europe and the USA. We assessed 12 single markers and 18 multimarker panels. The reference standard was centrally scored liver histology according to the non-alcoholic steatohepatitis Clinical Research Network Scoring System. Target conditions included MASH (Non-Alcoholic Fatty Liver Disease Activity Score ≥4 with ≥1 point per component), at-risk MASH (MASH plus significant fibrosis [fibrosis stage F≥2]), advanced fibrosis (F≥3), and cirrhosis (F4). Performance was evaluated by area-under-the-receiver operating characteristic curve (AUC), with the minimum acceptable criterion (MAC) of AUC higher than 0·80 to indicate potential biopsy replacement.\nBetween Jan 1, 2018, and June 30, 2023, we analysed data from 1590 participants with centrally scored liver biopsies and at least one biomarker measurement; 609 (38%) had biopsy-confirmed at-risk MASH, 678 (43%) had MASH, 585 (37%) had advanced fibrosis, and 164 (10%) had cirrhosis. For detecting at-risk MASH, SomaSignal showed the highest diagnostic performance (AUC 0·83 [95% CI 0·80-0·85]), significantly exceeding MAC, whereas no other test reached the MAC for MASH only. For advanced fibrosis, SomaSignal showed the highest performance (AUC 0·92 [0·90-0·94]), followed by FibroMeter-VCTE (AUC 0·87 [0·83-0·92]), Agile 3+ and TSP2 (both AUC 0·84 [0·82-0·86]), and NIS4 (0·82 [0·80-0·85]). For cirrhosis, FibroMeter-VCTE showed the highest diagnostic performance (AUC 0·94 [0·90-0·97]) followed by SomaSignal (AUC 0·92 [0·90-0·94]), followed by Agile 3+ (0·88 [0·85-0·91]), Agile 4 (0·87 [0·84-0·90]), ADAPT (0·85 [0·81-0·88]), and ELF, LSM-VCTE, and TSP2 (all 0·84 [0·81-0·87]). Sequential two-step approaches using gamma-glutamyl transferase as a first-line test met the MAC for both advanced fibrosis and at-risk MASH.\nAlthough single markers resulted in variable and limited performance when compared to histology for detecting at-risk MASH, multimarker panels showed great potential, with a proteomic panel showing strong diagnostic performance. These findings could support the selection and implementation of non-invasive testing strategies in MASLD and inform future clinical guidelines, regulatory evaluation, and clinical trial design.\nInnovative Medicines Initiative 2 Joint Undertaking.",
"authors": [
"Vali Y",
"Wonders K",
"Lee J",
"Aithal GP",
"Aller R",
"Allison MED",
"Arola J",
"Banales JM",
"Bernal-Monterde V",
"Berzigotti A",
"Boursier J",
"Brass CA",
"Bugianesi E",
"Calleja JL",
"Cobbold JF",
"Cortez-Pinto H",
"Crespo J",
"Davies S",
"Driessen A",
"Duffin KL",
"Ekstedt M",
"Forton D",
"Fournier-Poizat C",
"Francque S",
"Geier A",
"Gogain J",
"Gouw ASH",
"Hagström H",
"Holleboom AG",
"Hytiroglou P",
"Karsdal M",
"Lackner C",
"Leeming DJ",
"Miele L",
"Papatheodoridis G",
"Paradis V",
"Pavlides M",
"Pericàs JM",
"Petta S",
"Ratziu V",
"Romero-Gomez M",
"Schattenberg JM",
"Schuppan D",
"Surabattula R",
"Silva AP",
"Kjær MS",
"Straub BK",
"Svegliati-Baroni G",
"Tiniakos D",
"Tonini MM",
"Torstenson R",
"Valenti LVC",
"Verheij J",
"Magnanensi J",
"Mayo R",
"Wenn D",
"Yki-Järvinen H",
"Yunis C",
"Bossuyt PM",
"Anstee QM",
""
],
"journal": "Lancet",
"volume": "408",
"issue": "10566",
"pages": "1850-1865",
"date": "2026Oct31",
"publication_types": [
"Journal Article",
"Multicenter Study",
"Observational Study"
],
"ids": {
"pubmed": "42956772",
"doi": "10.1016/S0140-6736(26)01145-1",
"pii": "S0140-6736(26)01145-1"
},
"corrections": []
},
"42925568": {
"pmid": "42925568",
"title": "High Prevalence of Pruritus, Fatigue, and Sleep Disorders in MASLD Negatively Affects Health-related Quality of Life and Work Productivity.",
"abstract": "Metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with health-related quality of life (HRQL) impairment, which can be exacerbated by pruritus, fatigue, and/or sleep disorders. We assessed the prevalence of significant pruritus, fatigue, and sleep disorders in patients with MASLD and evaluated their association with HRQL and work productivity loss.\nPatients with MASLD were prospectively enrolled into the Global NAFLD/MASLD Registry. Clinical and HRQL (per CLDQ-MASH and WPAI:SHP questionnaires) data were analyzed according to the presence of significant pruritus, significant fatigue, and sleep disorders.\nA total of 8034 patients with MASLD from 39 countries (age 54±12 years, 46% male, 50% type 2 diabetes, 39% advanced fibrosis) were included. At baseline, 25% reported significant pruritus, 35% significant fatigue, and 34% sleep disorders, and 10% had all 3 symptoms. Patients with fatigue, pruritus, or sleep disorder were more likely to be female, have higher BMI, more metabolic comorbidities, and greater psychiatric burden. At 1-year follow-up, over half of the patients with baseline symptoms continued to experience them, and 14% to 18% developed de novo symptoms. Multivariate analyses showed that significant pruritus and sleep disorders each independently predicted fatigue [OR=9.51 (8.0-11.3)] when both conditions were present. Pruritus was a strong predictor of sleep disorders [OR=2.90 (2.6-3.3)]. All 3 conditions, especially fatigue, were independently associated with significantly impaired HRQL and work productivity loss.\nClinically significant fatigue, pruritus, and sleep disorders are common in MASLD, having a negative impact on HRQL and a substantial economic burden.",
"authors": [
"Younossi ZM",
"Yilmaz Y",
"Yu ML",
"El-Kassas M",
"Castellanos Fernandez M",
"Eguchi Y",
"Papatheodoridis GV",
"Wong VW",
"Duseja AK",
"Singal AK",
"Hamid SS",
"Bugianesi E",
"Isakov VA",
"Gomez MR",
"Chan WK",
"Alswat K",
"Fan JG",
"Gordon SC",
"Roberts SK",
"George J",
"Méndez-Sánchez N",
"Keklikkiran C",
"Tcaciuc E",
"Racila A",
"Lam B",
"Henry L",
"Racila A",
"Stepanova M",
"Alqahtani SA",
""
],
"journal": "J Clin Gastroenterol",
"volume": null,
"issue": null,
"pages": null,
"date": "2026Oct22",
"publication_types": [
"Journal Article"
],
"ids": {
"pubmed": "42925568",
"doi": "10.1097/MCG.0000000000002458",
"pii": "00004836-990000000-00708"
},
"corrections": []
},
"42935238": {
"pmid": "42935238",
"title": "Long-term hepatic and extrahepatic outcomes in type 2 diabetes: final results of the prospective DM-FibroScan Study.",
"abstract": "International guidelines recommend routine liver assessment in patients with type 2 diabetes (T2D), but the long-term clinical implications remain unclear. We aimed to characterise the long-term hepatic and extrahepatic outcomes across the vibration-controlled transient elastography (VCTE) spectrum in T2D.\nThe prospective DM-FibroScan Study consecutively enrolled adults with T2D in Hong Kong during 2013-2014. Baseline controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were assessed.\n1,862 patients were followed for a median of 11.9 years (interquartile range 11.5-12.1). The 10-year cumulative incidence of liver-related events (LREs) was 1.1% (95% CI 0.7-1.7), lower than those of all cause mortality (21.1% [19.2-22.9]), cardiovascular events (12.5% [11.0-14.2]), malignancies (9.7% [8.3-11.1]), and end-stage kidney disease (9.0% [7.7-10.3]). Most participants (84.2%) had baseline LSM <10 kPa and a low LRE incidence (0.4 [0.1-0.8] per 1,000 person-years), with cardiovascular events predominated (14.1 [12.2-16.2] per 1,000 person-years). Patients with LSM >15 kPa (5.3%) exhibited a markedly higher LRE incidence (12.2 [6.1-21.8] per 1,000 person years), approaching the incidences of malignancies and ESKD. LRE incidence per 1,000 person-years was 1.9 in patients with LSM regression (≥10 to <10 kPa) and 28.0 in those with persistently elevated LSM. Patients with elevated baseline LSM also showed higher incidences of extrahepatic outcomes.\nLREs were relatively uncommon in the overall T2D population but increased substantially with advanced fibrosis. This study provides natural history data across the VCTE spectrum in a relatively unselected T2D cohort and supports integrating fibrosis assessment into routine T2D care.",
"authors": [
"Cai J",
"Yip TC",
"Lai JC",
"Wong GL",
"Luk AO",
"Kwok R",
"Chan JC",
"Lee HW",
"Shu SS",
"Chim AM",
"Kong AP",
"Sun J",
"Wong VW"
],
"journal": "Clin Mol Hepatol",
"volume": null,
"issue": null,
"pages": null,
"date": "2026Oct27",
"publication_types": [
"Journal Article"
],
"ids": {
"pubmed": "42935238",
"doi": "10.3350/cmh.2026.1023",
"pii": "cmh.2026.1023"
},
"corrections": []
},
"42920888": {
"pmid": "42920888",
"title": "Liver fibrosis risk, missed follow-up, and inequitable specialist referral in the All of Us Research Program: a retrospective cohort study.",
"abstract": "Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent and frequently undiagnosed, despite liver fibrosis being the strongest predictor of liver-related morbidity and mortality. We aimed to quantify Fibrosis-4 (FIB-4) index-based fibrosis risk and to evaluate guideline-recommended follow-up-FIB-4 documentation, confirmatory testing, and specialist referral-in a large US cohort.\nWe conducted a retrospective study of electronic health record data from the US All of Us Research Program. Among adults aged 35 years or older with sufficient laboratory data, FIB-4 scores were calculated from routinely captured biomarkers, classified as low (<1.3), indeterminate (1.3-2.67; 2.0-2.67 if aged ≥65 years), or high risk (>2.67), and described across sociodemographic and metabolic subgroups; associations with incident major adverse liver outcomes (MALO) were assessed with Cox proportional-hazards regression. We examined FIB-4 documentation, confirmatory testing, and specialty referrals within 365 days of the index FIB-4 date.\nAmong 136,004 participants (mean age 60.8 years [SD 13.5]; 79,365 [58.4%] female; 81,420 [59.9%] White, 21,779 [16.0%] Hispanic or Latino, 20,076 [14.8%] Black), 26,971 (19.8%, 95% CI 19.6-20.0) had indeterminate and 11,217 (8.2%, 8.1-8.4) high FIB-4-based fibrosis risk. Elevated risk was more frequent with cardiovascular disease (41.7% vs 25.6%), hypertension (30.7% vs 23.4%), and type 2 diabetes (29.7% vs 27.4%), rising from 25.6% with no metabolic comorbidities to 36.6% with four. FIB-4 documentation was rare, and fewer than 1% of high-risk participants underwent confirmatory testing or referral; referral was low across risk categories (0.19% high, 0.19% indeterminate, 0.25% low risk). MALO occurred in 1308 (11.7%) high-risk vs 830 (0.8%) low-risk participants (adjusted hazard ratio 19.68, 95% CI 17.88-21.67).\nRoutinely collected laboratory data identify substantial liver fibrosis risk in this volunteer US cohort, yet guideline-recommended follow-up is uncommon. Implementation strategies such as automated risk calculation and reflex-based testing pathways could reduce missed opportunities for earlier diagnosis and intervention.\nNo specific funding was received for this study.",
"authors": [
"Sellers K",
"White TM",
"Manolas MI",
"Hagström H",
"Brennan PN",
"Diaz LA",
"Bansal MB",
"Danpanichkul P",
"Zhang X",
"Lazarus JV"
],
"journal": "Lancet Reg Health Am",
"volume": "65",
"issue": null,
"pages": "101676",
"date": "2027Jan",
"publication_types": [
"Journal Article"
],
"ids": {
"pubmed": "42920888",
"pmc": "PMC13691157",
"doi": "10.1016/j.lana.2026.101676",
"pii": "S2667-193X(26)00306-6"
},
"corrections": []
},
"42929711": {
"pmid": "42929711",
"title": "Phase 1b study of miricorilant in patients with presumed metabolic dysfunction-associated steatohepatitis (MASH).",
"abstract": "Miricorilant, an oral nonsteroidal selective glucocorticoid receptor modulator, is being investigated as a therapy that modulates hepatic cortisol activity in patients with metabolic dysfunction-associated steatohepatitis (MASH). This phase 1b study evaluated miricorilant's efficacy and safety.\nSeventy patients with presumed MASH received oral miricorilant daily (30-150 mg) or intermittent (100-200 mg once, twice, or thrice weekly) dosing regimens for 12 or 24 weeks. Across dosing regimens, reductions in relative liver fat content (LFC) ranged from 10.1% to 76.6%. Improvements in MASH liver function markers and the enhanced liver fibrosis (ELF) score were observed across regimens. Treatment-emergent adverse events (TEAE) leading to drug interruption/discontinuation occurred in 12.9% of patients (n=9) each; most were due to aminotransferase elevations during an excessively rapid drop in LFC (up to 70.2% at week 6) and in patients receiving daily dosing. Intermittent dosing enabled more patients to complete 12 weeks of treatment without discontinuation due to TEAEs. Intermittent dosing with miricorilant 100 mg twice weekly had the best benefit-risk profile; this cohort demonstrated a mean LFC reduction of 28.2% at week 12, with a corresponding decline in liver enzymes (ALT, -3.8 U/L; AST, -6.0 U/L). Patients in this cohort also had numerical improvement in lipid profiles, glycemic markers, and fibrosis biomarkers.\nIntermittent miricorilant dosing of 100 mg twice weekly achieved meaningful reductions in LFC and improved liver health markers with a favorable safety profile. This regimen is being evaluated in the phase 2b MONARCH study (NCT06108219).",
"authors": [
"Alkhouri N",
"Rudraraju M",
"Leibowitz M",
"Jenders RA",
"Kohli A",
"Noureddin M",
"Patil R",
"Tudor IC",
"Botbyl J",
"Kunta JR",
"Kesner-Hays A",
"Monibas RM",
"Espinueva AA",
"Juneja K",
"Kowdley KV"
],
"journal": "Hepatology",
"volume": null,
"issue": null,
"pages": null,
"date": "2026Oct26",
"publication_types": [
"Journal Article"
],
"ids": {
"pubmed": "42929711",
"doi": "10.1097/HEP.0000000000001886",
"pii": "01515467-990000000-01696"
},
"corrections": []
},
"41990758": {
"pmid": "41990758",
"title": "Global burden of metabolic dysfunction-associated steatotic liver disease, 1990-2023, and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2023.",
"abstract": "Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease, is one of the most prevalent liver diseases globally, contributing to both economic and health-related challenges. We aimed to evaluate the global, regional, and national burden of MASLD from 1990 to 2023, quantify the contribution of identified modifiable risk factors, and project future prevalence up to the year 2050.\nEstimates of MASLD prevalence and disability-adjusted life-years (DALYs) were produced by age, sex, region, Socio-demographic Index (SDI), and Healthcare Access and Quality (HAQ) index across 204 countries and territories from 1990 to 2023 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023. The MASLD burden attributable to three risk factors (smoking, high BMI, and high fasting plasma glucose) was assessed as part of the GBD comparative risk assessment. As a secondary analysis, we used these estimates to forecast MASLD prevalence up to 2050 using fasting plasma glucose and mean BMI as predictors. Furthermore, to examine the relative contributions of population ageing, population growth, and changes in MASLD prevalence rate to the forecasted changes in case counts from 2023 to 2050, we conducted a decomposition analysis.\nIn 2023, approximately 1·3 billion (95% uncertainty interval [UI] 1·2 to 1·4) individuals were estimated to be living with MASLD (ie, 16·1% of the global population), with an age-standardised prevalence rate of 14 429·3 (95% UI 13 268·3 to 15 990·6) per 100 000 population, representing a percentage increase of 142·7% (95% UI 139·2 to 146·7) in crude numbers from 1990 (0·5 billion [0·5 to 0·6]) and of 28·6% (27·8 to 29·5) in the rate (11 217·2 [10 276·8 to 12 467·0] per 100 000 in 1990). An estimated 3·6 million (2·8 to 4·5) total DALYs were attributable to MASLD worldwide in 2023, corresponding to an age-standardised DALY rate of 39·6 (31·2 to 49·9) per 100 000 population. Despite a 116·3% (93·3 to 139·4) increase in crude DALYs (from 1·7 million [1·3 to 2·1] in 1990), its age-standardised estimate remained consistent (1·8% [-8·6 to 12·8]) from 1990 (38·9 [30·1 to 49·8] per 100 000) to 2023. There was substantial variation in age-standardised estimates across regions. North Africa and the Middle East had the highest prevalence rate (29 246·1 [26 848·3 to 32 048·7] per 100 000) and Andean Latin America showed the highest DALY rate (152·3 [114·1 to 194·7] per 100 000). By contrast, the high-income Asia Pacific region had the lowest prevalence rate (8653·5 [7923·7 to 9592·8] per 100 000) and east Asia had the lowest DALY rate (16·3 [13·5 to 19·9] per 100 000) among all GBD regions. North Africa and the Middle East showed disproportionately higher prevalence rates relative to other regions with similar SDIs. Lower SDIs and HAQs were associated with higher age-standardised DALY rates. The age-standardised prevalence rate was consistently higher in males (15 616·4 [14 349·2 to 17 263·3] per 100 000 people in 2023) than in females (13 245·2 [12 132·0 to 14 692·6] per 100 000 people), and peaked at age 80-84 years in both sexes. The number of MASLD prevalent cases was the highest in younger adults, peaking at age 35-39 years for males and age 55-59 years for females. Among the risk factors for MASLD, high fasting plasma glucose presented the largest contribution to the age-standardised DALY rate of total MASLD in 2023 (2·2 [95% UI 1·6 to 3·1] per 100 000 people), followed by high BMI (1·4 [0·6 to 2·4] per 100 000 people) and smoking (1·0 [0·3 to 1·8] per 100 000 people). Our forecasting model estimates that 1·8 billion (95% UI 1·6 to 2·0) individuals are likely to have MASLD by 2050, representing a 42·0% increase from 2023. The age-standardised prevalence rate is expected to increase to 15 774·9 (95% UI 14 613·9 to 17 336·2) per 100 000 people in 2050, representing an average annual percentage change of 0·3% (95% UI 0·3-0·3). According to our decomposition analysis, this change will be primarily due to population growth, particularly in sub-Saharan Africa and North Africa and Middle East, and less by population ageing or epidemiological change.\nWith a global prevalence of 16·1% and approximately 1·3 billion people already living with MASLD in 2023, the condition has and will continue to have substantial health and economic impacts worldwide. An inverse association between the HAQ Index and age-standardised DALY rates suggests that countries with lower health-care access and quality might be less well positioned to manage the growing MASLD burden, underscoring the need for strengthened health-system capacity in these settings.\nGates Foundation.",
"authors": [
"GBD 2023 MASLD Collaborators"
],
"journal": "Lancet Gastroenterol Hepatol",
"volume": "11",
"issue": "6",
"pages": "463-494",
"publication_types": [
"Journal Article",
"Research Support, Non-U.S. Gov't"
],
"ids": {
"pubmed": "41990758",
"doi": "10.1016/S2468-1253(26)00011-7",
"pii": "S2468-1253(26)00011-7"
},
"corrections": []
}
},
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"no_deep_notes": true,
"open_questions": [
"OQ-3 sharpened by negative AZD2693 registry histology",
"OQ-39 flagged for full-text reassessment of new LITMUS study"
],
"excluded": [
"Preclinical/animal studies, acronym-noise records, routine narrative reviews and small surrogate-marker association studies not selected",
"No non-PMID record survived triage; no DOI-only citation added",
"One PubMed Expression of Concern notice was excluded and its target was not found in the MASLD bibliography"
],
"earlier_source_completeness_additions": [
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],
"november_issue_earlier_online": [
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"source": "https://www.ebi.ac.uk/europepmc/webservices/rest/PMC13691157/fullTextXML",
"read": "Results, tables 1–6 and Discussion/limitations",
"evidence_excerpt": "rather than MASLD-specific disease alone",
"use": "bibliography only; mixed-aetiology/uncertain-diagnosis caveat prevents treating it as MASLD prevalence"
},
"Madrid_original": {
"url": "https://www.medicosypacientes.com/wp-content/uploads/2026/06/Declaracion-de-Madrid-sobre-la-Esteatosis-Hepatica-Metabolica-EHmet_.pdf",
"read": "text extracted; policy framework and provenance checked",
"version_caveat": "original Spanish declaration dated 29 May 2026; not assumed identical to October journal article"
},
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"42850047": "re-fetched PubMed: no abstract; BMJ full-text attempt HTTP 403; no findings inferred",
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},
"limitations": [
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"SciELO and LILACS search could not be searched (HTTP 403); LILACS homepage returned a maintenance page. No universal or regional-absence conclusion.",
"WHO ICTRP query blocked; CTIS page did not yield an extracted trial record. ISRCTN was successfully searched directly.",
"No new dated registry/burden or patient-organisation material warranted synthesis. Older GBD analysis catalogued for table-level appraisal.",
"No independent audit or publication/build/deployment performed; user reserved publishing and prohibited git."
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"validation": {
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