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Metabolic Dysfunction-Associated Steatohepatitis Diagnosis and Management in Germany: Insights From an Expert
Yestle Kim1, Peter Rydqvist1, Thomas Ramezani1
1Health Economics and Outcomes Research, Madrigal Pharmaceuticals Inc, West Conshohocken, Pennsylvania, USA.
Summary
Approximately 75% of metabolic dysfunction-associated steatohepatitis (MASH) patients in Germany are undiagnosed. Experts recommend lifestyle changes and non-invasive tests due to a lack of approved MASH treatments.
Area of Science:
- Hepatology
- Gastroenterology
- Metabolic Diseases
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease.
- Metabolic dysfunction-associated steatohepatitis (MASH), a progressive form of MASLD, can lead to fibrosis and cirrhosis.
- MASH incidence in Germany is projected to double by 2030, presenting significant diagnostic and management challenges.
Purpose of the Study:
- To achieve expert consensus on diagnostic pathways for MASH in Germany.
- To evaluate current treatment modalities for MASH in the German context.
Main Methods:
- A three-round Delphi panel survey conducted online from February to May 2024.
- Involved 12 specialists in gastroenterology, diabetology, and/or hepatology in Germany.
- Utilized a standard survey integrated with Delphi methodology to reach consensus.
Main Results:
- ~75% of MASH patients in Germany remain undiagnosed.
- Non-invasive measures (fibrosis scores, liver enzymes, liver stiffness) are primary diagnostic and monitoring tools.
- Lifestyle modifications are the main management strategy; approved pharmacological treatments are lacking.
Conclusions:
- Substantial underdiagnosis of MASH in Germany necessitates enhanced screening and early detection.
- Reliance on non-invasive diagnostics and lifestyle modifications is critical due to the absence of approved treatments.
- Standardized algorithms and improved management of comorbidities are essential for better patient outcomes.
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