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Driving the Discussion in Fatty Liver Disease. Join hepatology researcher and Key Opinion Leader Jörn Schattenberg, Liver Wellness Advocate Louise Campbell, and Forecasting and Pricing Guru Roger Green and a global group of Key Opinion Leaders and patient advocates as they discuss key issues in Fatty Liver disease, including epidemiology, drug development, clinical pathways, non-invasive testing, health economics and regulatory issues, from their own unique perspectives on the Surfing the MA ...
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Vision To Prevent and Cure Liver Disease Mission To advance and disseminate the science and practice of hepatology, and to promote liver health and quality patient care AASLD is the leading organization of scientists and healthcare professionals committed to preventing and curing liver disease. AASLD was founded in 1950 by a small group of leading liver specialists (including Hans Popper, Leon Schiff, Fred Hoffbauer, Cecil Watson, Jesse Bollman, and Sheila Sherlock, to name a few) to bring t ...
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Weekly updates on new data and best practices in patient care for a variety of infectious diseases including COVID-19, HIV, and viral hepatitis, from Clinical Care Options. Gain practical strategies and earn CME/CE credit for selected episodes.
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Earlier in this episode, the panel discusses different prescribing models for MASH drugs, triggered by Roger Green's question about whether MASH prescribing will resemble an oncology model. This conversation, from the EASL Congress 2023 wrap-up episodes, takes a very different view of the relationship between MASH and oncology. The conversation inc…
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This final conversation starts by considering prescribing models for other diseases and how they might work here, shifts to discussing the challenges of keeping a patient enrolled in a long-term clinical trial (or even participating in a trial in the first place), and moves on to the final question for the episode. The conversation picks up on the …
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This conversation sees the end of the "hot topics" discussion, followed by Michael Charlton discussing issues and excitement around the FGF-21 class. As we begin, Louise Campbell and Jörn Schattenberg speculate on ways to incorporate metrics like the Dietary Inflammation Index into multifactorial care. Michael asks whether alcohol is figured in the…
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After Michael Charlton finishes discussing research he finds compelling, Jörn Schattenberg and Louise Campbell each describe one item they have been focusing on recently. Michael mentions the recent JAMA publication of a small, randomized controlled trial exploring the use of low-dose aspirin in biopsy-confirmed MASLD patients, which he describes a…
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Michael Charlton and the Surfers discuss two issues: defining therapeutic futility for Rezdiffra and describing some advances in MASLD translational medicine. The conversation starts by continuing the topic of therapeutic futility. Louise Campbell asks Michael how he plans to determine therapeutic futility with Rezdiffra in terms of side effects or…
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In this initial conversation, Michael Charlton describes some ways that the presence of Rezdiffra has affected practices and procedures in his clinic and shares issues he and his colleagues are discussing. As the conversation begins, Michael hails Rezdiffra as proof that as a species, "we can be capable of amazing things in a good way," a drug appr…
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Michael Charlton joins Jörn Schattenberg, Louise Campbell, and Roger Green for a far-reaching conversation that covers ways Rezdiffra is already impacting MASH patient treatment, exciting recent studies and broader issues in clinical trial recruitment. 00:00:00 - Surf's Up: Season 5 Episode 11 Opening comments from the panel, including brief quotes…
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This episode is a follow-up to Season 4, Episode 5, where we met Tim Jobson. His company, Predictive Health Intelligence (PHI), takes a unique approach to identifying and monitoring MASLD patients using basic EHR data and analytics. This session explores PHI's work over the past years and considers implications for several liver-related health chal…
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In this episode, Gregory Huhn, MD, MPHTM, uses a case study to explore the reasons healthcare professionals and people living with HIV may want to further optimize ART in the setting of viral suppression. To determine the best outcome for this case study, Dr Huhn discusses the reasons individuals may not be satisfied with daily oral ART and examine…
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In this episode, Maria Buti, MD, and her patient discuss opportunities to optimize care for people living with hepatitis B virus (HBV), including: Barriers to HBV screening, including patient- and provider-specific barriers (eg, lack of education, failure to disclose or discuss risk factors, perceived low risk, stigma) Applying CDC recommendations …
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This conversation comes from our coverage of The EASL Congress, 2023, when Sven Francque and Ian Rowe joined Jörn Schattenberg and Roger Green to consider primary care screening at the top of the Clinical Care Pathway. The original conversation had a robust write-up: Ian starts this conversation by pointing to unmet needs in the primary care settin…
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This conversation focuses on how the need for biomarkers will evolve in an era of in-office screening and MASH drugs and ends with answers to Roger Green's closing question. Hannes Hagstrom starts this conversation by noting that one challenge as MASH drugs become available involves knowing when to discontinue or add to therapy since, as he points …
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This conversation explores the implications of increased access to economically viable in-office screening, particularly when primary care practices begin to use the new scanning devices. Roger Green begins this conversation by recalling a concern Naim Alkhouri expressed during S4 E50.3, that primary care reliance on FIB-4 can flood the pathways wi…
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This conversation centers around the different kinds of impact that in-office scanning can have on MASLD therapy, both in terms of improved prognostics and better overall outcomes. Roger Green starts by suggesting that the recent commercialization of a second VCTE in the U.S. (specifically, Hepatoscope from e-Scopics), coupled with increased promot…
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This conversation explores why different nutrition interventions might help MASLD patients improve their overall liver health and what lessons treaters and researchers can learn from this. It starts with Louise Campbell discussing a recent publication of a pilot study from Armandi et al. (including Jörn Schattenberg as a co-author) evaluating the a…
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This conversation focuses on the role of VCTE in diagnosing, staging and treating MASLD patients, both in terms of prognostic ability of VCTE when compared to biopsy and separately as a therapeutic adjunct. It starts with Hannes Hagstrom and Jörn Schattenberg discussing a study from Vincent Wong and a large group of co-authors, including Hannes,, t…
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Hannes Hagstrom joins Jörn Schattenberg, Louise Campbell and Roger Green to discuss recent research panelists have conducted. This content-dense conversation focuses initially on the impact of VCTE and other forms of in-office monitoring and branches out from there. 00:00:00 - Surf's Up: Season 5 Episode 9 Opening comments from the panel, including…
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With Louise Campbell and Jörn Schattenberg both on Easter Week vacations, Fatty Liver Alliance Founder Mike Betel joins Roger Green to continue a brief conversation they began in a post from the Fatty Liver Alliance last weekend. This conversation focuses largely on how patient incentives to participate in MASH clinical trials might need to change …
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In this episode, Joseph J. Eron, Jr., MD, and Monica Gandhi, MD, MPH, discuss the key HIV studies from CROI 2024 that are influencing their clinical practice, including: New data surrounding long-acting ART, including: The CARES study of LA CAB + RPV in a Sub-Saharan African population using a public health approach The IMPAACT 2017 MOCHA study eva…
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In this episode, Mark S. Sulkowski, MD, FIDSA, FAASLD; Tatyana Kushner, MD, MSCE; Paul Y. Kwo, MD; and patient advocate Jacki Chen, PhD, consider barriers and solutions for more expansive HBV treatment in the United States. Topics include: Patient subgroups to consider for treatment outside guideline criteria Adverse event and cost-effectiveness co…
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So far, this conversation has focused on Rezdiffra approval and its many forms of impact on MASLD patient advocates. This conversation considers their recommendation for others. The conversation starts with Roger Green's final question. He asks each panelist to identify a stakeholder group that can take a valuable lesson from this episode and what …
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This conversation asks what impact Rezdiffra patient education might have on a U.S. healthcare system in which 38% of American adults live with some form of MASLD and 15% live with MASH. Louise Campbell starts off by saying she is “slightly fed up” with the idea that we cannot proceed too quickly for fear of overwhelming the system. Louise would ra…
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This conversation focuses on how the role of MASLD patient advocates might change and expand in the aftermath of Rezdiffra being approved. To Wayne Eskridge, this “raises an entirely new field of education and outreach,” because now advocates can do more than merely be supportive emotionally. Advocates can, quoting again, “refresh our message and h…
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This conversation focuses on the steps that patient advocates took to educate the FDA on what patients wanted in a MASH drug label, in this case for Rezdiffra. It starts with Jeff McIntyre reflecting on apparent changes in how the FDA thinks about labeling since the initial obeticholic acid Complete Response Letter in 2020. His specific point: sinc…
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This conversation focuses on advocates' reactions throughout the day on Thursday, March 14, the day Rezdiffra became the first MASH drug approved in the U.S. Specifically, panelists discuss their thoughts and feelings as they reflected on Rezdiffra’s approval in the context of their personal experience. While no panelist is eligible to receive Rezd…
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This conversation focuses on two issues: (i) identifying the right target MASH patients for Rezdiffra, and (ii) the extensive Madrigal patient support program for Rezdiffra. It starts with Roger Green asking the group how the current set of target patients is defined. Jeff McIntyre points out that these are the patients currently treated for F2 or …
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Last Thursday, March 14, Rezdiffra (resmetirom) became the first drug approved in the US for MASH. Five leading North American MASLD patient advocates join the Surfers to discuss their feelings about this approval along with the opportunities and challenges that lie ahead. 00:00:00 - Surf's Up: Season 5 Episode 7 Opening introduction from an excite…
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As the conversation wound down, Roger Green offered panelists to address any issue pertaining to Rezdiffra, the first MASH drug, that had not come up in the hour-long conversation. The seven panelists raised eleven exceptionally diverse issues between them. Rather than provide a simple list of issues, the co-hosts invite you to listen to this short…
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This conversation revolves around one question: "What lessons should the BioPharma industry take from the launch of Rezdiffra?" Answers revolve largely around clinical trial design and, generally, taking a broad, long-term view of what the trial must accomplish to optimize drug adoption. More specifically, Roger Green starts this conversation by no…
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One pivotal question surrounding the launch of Rezdiffra is "Which MASH patients are the correct targets for the first MASH drug?" This conversation focuses on the tools and education the health system will need to locate these patients and have them treated by the appropriate prescribers. The conversation starts by considering educational goals. Z…
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This conversation focuses on the necessity of using NITs to screen and identify Rezdiffra patients, while at the same time acknowledging the shortcomings of current tests. Panelists suggest some different NIT testing strategies while commenting on upsides and potential challenges for each MASH NIT. Laurent Castera joins the conversation at the begi…
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This conversation focuses on what panelists see as a key (and somewhat unusual) benefit of Rezdiffra: that having a prescription drug for MASH creates a better environment for discussing lifestyle intervention and improving overall patient adherence with diet and exercise. This conversation focuses on the impact of having a drug on getting patients…
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FDA approval of the first MASH drug, Rezdiffra, on March 14 marked what co-host and Key Opinion Leader Jörn Schattenberg describes as a "watershed moment" for hepatology. This opening discussion covers how panelists heard the news of Rezdiffra's approval, how they reacted, and their initial thoughts about appropriate patient targets. As the convers…
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Last Thursday, March 14, Rezdiffra (resmetirom) became the first MASH drug approved in the US. A global panel of Key Opinion Leaders convenes to discuss their excitement about this approval, the opportunities it will create and some of the (largely manageable) challenges it might present. 00:00:00 - Surf's Up: Season 5 Episode 6 Opening introductio…
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In this episode, Robert Wong, MD, MS, and a patient discuss opportunities to optimize care for people living with hepatitis B virus (HBV), including: Opportunities to improve patient education, including education for expectant mothers with HBV Potential cultural considerations that may result in delayed HBV diagnosis and care Stigma reduction with…
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This conversation comes from our first look at MASEF, last September, when lead author Mazen Noureddin joined the Surfers to discuss his recent breakthrough paper on this new NIT. The original conversation had a robust write-up: Mazen Noureddin joins co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to discuss serum identification of at-r…
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After some final discussion about GLP-1s, this conversation entails Roger Green summarizing what he has heard in the episode so far and testing for confirmation or correction. It goes fast and covers significant ground. Naim Alkhouri starts this conversation by discussing patients for whom he would prescribe resmetirom vs. GLP-1s. Lean MASH patient…
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This conversation touches on two important subjects: the impact of different potential resmetirom prices on the size and structure of the treatable MASH population, and the impact GLP-1s are having (and will have) on clinical trial recruitment and basic patient treatment. It starts with Naim Alkhouri expressing concern over the $39-52K price he has…
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This conversation focuses more tightly on the specific challenges with the current approaches that use NITs to diagnose and stage advanced MASH fibrosis and explores several newer options and ways of thinking about the challenge. Roger Green notes that recent papers discuss the failure to predict accurately with FIB-4. He asks how we can improve pr…
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This conversation explores the challenges with using the current non-invasive tests (NITs) to diagnose patients with F2/F3 advanced MASH fibrosis. If tests today cannot achieve the requisite level of precision, panelists explore other ways to define patient targets. Roger Green starts by recalling that in a recent episode (Season 5 Episode 2), Jeff…
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This conversation explores why proper use of non-invasive tests (NITs) will play a pivotal role in increasing the number of patients diagnosed and treated for MASH. It becomes particularly pivotal if, as expected, the first MASH drug is approved later this month. Roger Green starts this conversation by describing why he considers NIT use and adopti…
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Listen to Roger Bedimo, MD, MS, FACP, discuss considerations for older people living with HIV, including: Polypharmacy and deprescribing The risk of cardiovascular events with various ART regimens Approaches for managing weight gain Presenter: Roger Bedimo, MD, MS, FACP Professor of Medicine Interim Director, Office of Global Health UT Southwestern…
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In 2024, the two major areas for change in diagnosing and treating MASH are new drug approval and changes in use of NITs. Naim Alkhouri and Ian Rowe join Jörn Schattenberg, Louise Campbell and Roger Green to consider what might change with NITs and how having an approved drug might change thinking on this issue. 00:00:00 - Surf's Up: Season 5 Episo…
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In this episode, Dr. Bedimo discusses best practices for individualized care in transgender women living with HIV, including: Providing services in a gender-affirmative care model Proactive counseling on drug-drug interactions with gender-affirming hormone therapy Strategies to reduce adverse events Presenter: Roger Bedimo, MD, MS, FACP Professor o…
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Two years ago, Surfing the MASH Tsunami conducted two episodes with Chris Estes, then the chief modeler for the Center for Disease Analysis Foundation exploring issues around CDAF's then-recent publication of a NASH/MASH disease model. This conversation centers on issues of advanced fibrosis. We thought it might be interesting to look back at that …
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As the episode comes to an end, the group winds up focusing on the need for better, more frequent MASH education as a pivotal need if we are to flatten the growth curve of the MASLD pandemic. In the process, the discussion returns to the risk for women and the important role they can play. Louise Campbell starts this conversation by harkening back …
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This conversation focuses largely on the work of the Global NASH Council, an effort of over 200 stakeholders in more than 50 countries to address a range of macro issues in the MASLD space. Zobair Younossi, who is the Global NASH Council Chair, starts this conversation by discussing a specific Global NASH Council project on how to implement guideli…
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In this opening conversation on MASLD disease burden, Zobair Younossi summarizes and expands on some key points from the recent Diabetes Spectrum review article he co-authored with Linda Henry. Zobair starts by discussing the recent review article, Understanding the Burden of Non-Alcoholic Fatty Liver Disease: Time for Action which he describes as …
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Initially, this conversation focuses on how cost-effectiveness issues relate to the MASLD Disease Burden. In the process, Zobair Younossi provides education on some of the metrics and concepts pivotal to drug value assessment. Roger Green starts off asking how the economics of treating MASH stack up against hypercholesterolemia at the birth of stat…
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This conversation starts with a focus on slowing the growth of the MASLD pandemic, and then veers slightly into a discussion of the specific issues post-menopausal women face with MASLD. Roger Green starts by commenting how it seems both pivotally important and highly efficient to find a way to flatten the growth curve, and he asks Zobair what he c…
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