Clinical Outcomes and Non-Invasive Testing in Metabolic Dysfunction-Associated Steatohepatitis With Cirrhosis: A...

Area of Science:

• Hepatology
• Gastroenterology
• Clinical Research

Background:

• Metabolic dysfunction-associated steatohepatitis (MASH) with cirrhosis presents a growing global health challenge with few definitive treatments.
• Understanding the disease burden in MASH-related cirrhosis is crucial for developing effective management strategies.

Purpose of the Study:

• To conduct a systematic literature review (SLR) to assess the clinical outcomes and disease burden in patients with MASH-related cirrhosis.
• To evaluate the role of non-invasive tests (NITs) in predicting clinical outcomes in this patient population.

Main Methods:

• A systematic literature review adhering to PRISMA guidelines was performed, searching Embase, MEDLINE, and Cochrane Library for studies published between 2014-2024.
• Included studies focused on clinical outcomes such as transplant-free survival, decompensation events, and hepatocellular carcinoma (HCC) in MASH-related cirrhosis.
• The review also examined the utility of non-invasive tests for predicting these outcomes.

Main Results:

• 317 studies were included, revealing limited and heterogeneous data on transplant-free survival, decompensation, and HCC in MASH cirrhosis.
• Type 2 diabetes (T2D) was associated with lower transplant-free survival and increased decompensation risk.
• Risk factors for HCC included male sex, T2D, and high Child-Turcotte-Pugh score. NIT performance varied due to differing outcome definitions.

Conclusions:

• The SLR identified data on various clinical outcomes in MASH cirrhosis but highlighted a significant lack of evidence regarding prognostic prediction models for liver-related events.
• Further research is needed to establish reliable predictive tools for managing MASH-related cirrhosis.