Surfing The MASH Tsunami podcast

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Carol Costello Presents: The God Hook

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1 | The False Prophet 35:56

14일 전35:56

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35:56

In this premiere episode of "The God Hook," host Carol Costello introduces the chilling story of Richard Beasley, infamously known as the Ohio Craigslist Killer. In previously unreleased jailhouse recordings, Beasley portrays himself as a devout Christian, concealing his manipulative and predatory behavior. As the story unfolds, it becomes clear that Beasley's deceitfulness extends beyond the victims he buried in shallow graves. Listen to the preview of a bonus conversation between Carol and Emily available after the episode. Additional info at carolcostellopresents.com . Do you have questions about this series? Submit them for future Q&A episodes . Subscribe to our YouTube channel to see additional videos, photos, and conversations. For early and ad-free episodes and exclusive bonus content, subscribe to the podcast via Supporting Cast or Apple Podcasts. EPISODE CREDITS Host - Carol Costello Co-Host - Emily Pelphrey Producer - Chris Aiola Sound Design & Mixing - Lochlainn Harte Mixing Supervisor - Sean Rule-Hoffman Production Director - Brigid Coyne Executive Producer - Gerardo Orlando Original Music - Timothy Law Snyder SPECIAL THANKS Kevin Huffman Zoe Louisa Lewis GUESTS Doug Oplinger - Former Managing Editor of the Akron Beacon Journal Volkan Topalli - Professor of Criminal Justice and Criminology Amir Hussain - Professor of Theological Studies Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://evergreenpodcasts.supportingcast.fm…

Surfing the MASH Tsunami

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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 MASH Tsunami podcast. #MASH #MAFLD #FattyLiver #livertwitter #AASLD #GlobalLiver #NoNASH #EASL

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#Fitness #Medicine #Fatty Liver #Science #Natural Sciences #SurfingNASH.com #Masld #MASH #Mafld

Surfing the MASH Tsunami

updated 17일 전

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1041 에피소드

#Fitness #Medicine #Fatty Liver #Science #Natural Sciences #SurfingNASH.com #Masld #MASH #Mafld

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Surfing the MASH Tsunami

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S6 - E6 - Remembering Stephen Harrison and His Many Contributions to MASH 57:17

17일 전57:17

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57:17

00:00:00 Surf's Up, Season 6, Episode 6. On April 23, 2024, our colleague and co-founder, Stephen Harrison, passed away suddenly. This week, Surfing the MASH Tsunami remembers Stephen with two of his closest associates and continues our annual MASH Drug Development roundtable held in his honor. 00:00:04:24 - A Deep Dive into Drug Development, Part 2 The second portion of the Drug Development roundtable primarily focuses on three key issues. The first, uptake of resmetirom, starts with Naim Alkhouri discussing his experience in the Arizona Liver Health Clinics with over 650 patients in the year since resmetirom was approved and shifts to the various European panelists (Jörn Schattenberg, Louise Campbell and Sven Francque) estimating when it might be approved in their countries and how widely it might be reimbursed. The second topic, incretin agonists, focuses on exciting prospects for other incretin agonists in development, as well as some semaglutide combination therapies. The third, NIT clinical trials, covers prospects that non-biopsy clinical trials might be approved sometime in the near future. 00:16:20 - Remembering Stephen Harrison I: An Interview with Summit Clinical Research CEO Gail Hinkson Summit CEO Gail Hinkson joins Roger Green for the first time on SurfingMASH to discuss her business partner. Gail discusses how the two originally formed Pinnacle Clinical Research and how Pinnacle led to Summit. She proceeds to discuss the current size and reach of both Pinnacle and Summit. Focusing on Summit, Gail describes the company as an Integrated Research Organization (IRO), highlighting its distinct role within the MASH firmament. In the final section of the interview, Gail discusses how Stephen's personality, goals, and vision continue to live on at Summit today. 00:34:31 - Remembering Stephen Harrison II: An Interview with Naim Alkhouri Announcing That He Is Joining Summit Newly announced Summit Chief Academic Officer Naim Alkhouri joins this episode for a second time, but in a very different role. Naim discusses his personal history with Stephen and what he loved and respected about his "dear friend." He then makes a major announcement: he is joining Summit as Chief Academic Officer. He shares the many elements of this role, particularly his excitement that Summit can become the entity that educates a wide range of healthcare and commercial professionals on what MASH is and how it is treated. The scope of this vision, combined with what Gail discussed, portrays a level of energy, ambition and vision worthy of Stephen Harrison. 00:55:55 - Conclusion As part of this memorial week, Roger Green forgoes the usual business report, which will return next week.…

Surfing the MASH Tsunami

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S6 - E5.2 - Newsmaker: Naga Chalasani on Real-World Experience Prescribing Resmetirom 26:18

19일 전26:18

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26:18

This weekend’s Newsmaker, Indiana University hepatologist and key opinion leader Naga Chalasani, joins Roger Green to discuss Early Experience with Resmetirom To Treat Metabolic-Associated Steatohepatitis with Fibrosis in a Real-World Setting, an article his group published recently in Hepatology Communications. He shares highlights from the paper and points out the one key area in which his group found room for improvement in their initial protocol. Naga and colleagues wrote this paper after learning from Madrigal Pharmaceuticals that they were among the largest early prescribers of resmetirom and, relative to others, had achieved reimbursement with virtually all their patients and a high percentage of patients actually starting the medication. After receiving requests from other states for advice, the group decided to author this paper. In the paper, Naga and colleagues focused on patient selection, care pathway, how IUHealth got the medicine to their patients, and experience with safety and tolerability. In the paper, Naga and colleagues discuss their experiences in prescribing resmetirom for 113 patients in the first seven months after resmetirom's approval. Of these, IUHealth succeeded in achieving reimbursement for 110 of them. Of these patients, 83 initiated therapy, and 16% of those discontinued. In this interview, Naga shares some of the decisions that made the group so successful in the first three areas and identifies one subsequent area where the group found an opportunity for improvement: systematic follow-up with patients after prescribing. He attributes the 16% discontinuation rate to a "prescribe and forget" policy, similar to one that was successful in HCV, where clinicians prescribed without systematic follow-up until blood levels were obtained three months later. With a "prescribe and follow up" policy that includes phone calls at 1 and 3 months, he anticipates discontinuation rates will fall to something akin to the 5% rate in Phase 3 trials. What makes this interview so fascinating is Naga's description of the thinking that went behind specific decisions the group made in terms of patient management and pathway and suggests other options that might work as well. In all, this interview provides an excellent guide for clinics and providers on how to best integrate resmetirom into their practices.…

Surfing the MASH Tsunami

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S6 - E5.3 - Expert: Scott Friedman on Gene Therapy and Advances in Liver Science 23:23

19일 전23:23

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23:23

This week’s expert, Hepatologist and Key Opinion Leader Scott Friedman, joins Roger to discuss advances in acceptance of gene therapy and knowledge in other areas of basic liver science. When discussing science, he pays particular attention to findings on the diversity of stellate cells and his interest in CAR-T as a therapy for liver disease. This conversation starts with Scott discussing gene therapy. Specifically, he applauds the idea that gene therapy is becoming accepted in many diseases after a faulty start years ago, due to an unfortunate patient death in a badly controlled trial. He comments that this acceptance has unique benefits in liver disease because the liver can regenerate so much faster and more efficiently than other organs. He mentions some of the rare liver diseases in which patients are benefiting from gene therapy, and notes that we now have gene therapies and early-stage trials to target PNPLA3 and other genes associated with MASH and MASH cirrhosis. Next, Scott discusses stellate cells, which he has discussed in earlier episodes of SurfingMASH. Science is increasingly demonstrating how many different types of heterogeneous stellate cells exist. As Scott puts it, these cells "come in many flavors," each of which plays a different role in cell generation or cell death. In fact, the specific therapeutic challenges that present themselves may vary as a patient moves along the pathway from F1 to F2 to F3 to F4. Further, we are learning that there may be several different forms of MASH to present differently at a cellular level. This makes tremendous sense, given that no one drug has proven successful in even a significant majority of patients yet. As the conversation winds down, Scott shares what he describes as a "sobering note" about the state of research funding in America in 2025. As he notes, there are certain kinds of applied and developmental research that private companies do well, but other kinds of basic research that only occur when funded in public and not-for-profit sectors. As a specific example, he cites CRISPR, initially funded publicly and now in the hands of biotech companies, which is used to treat a variety of diseases more effectively than they could have been treated before, if at all. He also comments that a poor early commercial decision slowed the development of statins.…

Surfing the MASH Tsunami

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S6 - E5.1 - FGF-21s and A Promising Future on Cirrhosis 24:24

21일 전24:24

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24:24

This conversation is the opening segment of SurfingMASH's April discussion, in memory of Stephen A. Harrison, on drug development. In addition to co-hosts Jörn Schattenberg, Louise Campbell and Roger Green, panelists include hepatologists and key opinion leaders Sven Francque and Naim Alkhouri. This opening discussion focuses on exciting advances in one drug class (FGF-21s) and, more broadly, on exploring ways to treat cirrhosis. As Naim points out in his opening comment, these two issues— cirrhosis as a challenge and FGF-21s as a possible solution path —intersect in clear and exciting ways. He notes that the FGF-21 efruxifermin has been reported to have significant improvement in patients with cirrhosis, while the FGF-21 pegozafermin has shared positive results in a small cohort of patients. He also notes that a third FGF-21, efimosfermin alfa, has results in advanced non-cirrhotic MASH that suggest potential for similar efficacy in patients with cirrhosis, but this must be studied and confirmed in clinical trials. He mentions that resmetirom may also be showing signs of efficacy in some patients with cirrhosis. The entire package, he says, is a "game changer." Jörn notes that we are having parallel advances in treatment for advanced, non-cirrhotic patients. Sven concurs and comments that we are seeing effects that are not strictly related to metabolic disease. There is exceptional power that we can demonstrate one-level regression in sicker patients. The three agree that, at the same time, we are seeing cirrhosis trials that will lead to outcomes data; outcomes trials in non-cirrhotic medications may not be far away. Roger asks whether we are making progress in treating patients living with decompensated cirrhosis. Sven discusses what we are learning about treating portal hypertension, which is an important benefit unrelated to fibrosis regression. Simply improving portal hypertension will have an impact on endpoints. Naim points out that some ongoing trials include patients with cirrhosis, including survodutide and belapectin. Louise notes it will require "great P.R." to reverse some of the current perceptions about cirrhosis, but that this is "great." Naim states that even today, we have "a lot to offer" patients with portal hypertension or other symptoms of decompensation. As he concludes, he notes that this is underappreciated today.…

Surfing the MASH Tsunami

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S6 - E5 - Drug Development Week: FGF-21s, Cirrhosis, Resmiterom, Gene Therapies 1:09:00

25일 전1:09:00

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1:09:00

00:00:00 - Surf's Up: Season 6 Episode 5 Host Roger Green briefly describes this episode’s three sections and introduces Roundtable guests. The Roundtable panel shares groundbreakers. 00:10:39 - Roundtable: A Deep Dive Into Drug Development, Part One The opening portion of this month's roundtable centers around two issues: exciting data for FGF-21s and, more generally, treating patients with cirrhosis. Naim Alkhouri sets the tone in his opening comments, which start by focusing on the exciting SYMMETRY data from efruxifermin and then hones in on FGF-21s and resmetirom in cirrhosis. The rest of the conversation features Jörn Schattenberg, Sven Francque and Naim discussing therapies in development for compensated and decompensating cirrhosis. 00;24:44 - Newsmaker: Naga Chalasani on Real-World Experience Prescribing Resmetirom Naga joins Roger to discuss the paper Early Experience with resmetirom to treat Metabolic Dysfunction-Associated Steatohepatitis With Fibrosis in a Real-World Setting from his group at Indiana University, which his group authored and Hepatology Communications recently posted. The paper, based on IU Health's experience with its first 113 resmetirom patients, shares the group's practical experience developing processes to work closely with the specialty pharmacies dispensing resmetirom and, finally, concludes that a more engaged patient management strategy might reduce drug discontinuation to a level comparable with clinical trials. 00:47:21 - Expert: Scott Friedman on Gene Therapy, Diversity of Stellate Cell Types, Other Basic Liver Science Scott and Roger cover a range of basis science topics in a fast-moving 19-minute discussion. It starts with Scott discussing the increasing acceptance that gene therapy is an acceptable way to treat a range of liver diseases, many of which are orphan or ultra-orphan but, in fact, include potential gene therapies for non-cirrhotic MASH and MASH cirrhosis. He notes that in addition to classic gene therapy, which introduces protective gene variants into the systems of patients with the risky variants, gene therapy is now looking to introduce FGF-21 into patients through genetic modification. From there, the conversation covers CAR-T therapy, the increasing ability to identify many different types of stellate cells and the idea that the most effective therapy for eary fibrosis, advanced fibrosis and cirrhosis might require fundamentally different kinds of interventions. The two final elements are the idea that what we now call "MASH" may be several diseases with different etiologies with similar manifestations and a passionate call for all of us to support maintaining NIH funding in whatever ways we can. 01:06:45 - Business Report As Roger copes with his laryngitis, AI voices deliver an abbreviated business report…

Surfing the MASH Tsunami

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S6 - E4.3 - Expert: Mazen Noureddin Reviews the Exciting MASLD Drug Development Environment 24:34

30일 전24:34

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24:34

This week's expert, Hepatologist and Key Opinion Leader Mazen Noureddin, joins Roger to discuss major advances in drug development over the past year. He covers a range of different drug classes, focusing on stages of development and the range of options within each class. First, Mazen discusses a tremendously exciting group of FGF-21 agents, specifically mentioning Akero Therapeutics's efruxifermin, 89bio's pegozafermin, and Boston Pharmaceuticals's efimosfermin. He points to efruxifermin’s 96-week results to suggest that FGF-21s might be appropriate for a wide range of patients, the idea that the drug's duration of effect may make the idea of “induction therapy” less appropriate, and the exciting early data on cirrhosis patients. He also mentions pegozafermin's publication of data in the New England Journal of Medicine and efimosfermin's promising data based on monthly dosing. Next, Mazen provides some detail on the various incretin agonist options, why hepatologists are particularly excited about combinations that include a glucagon agent, and what kinds of results we might expect in upcoming trials. Finally, Mazen discusses other promising compounds in later-stage development, including the pan-PPAR lanifibranor and the FASN inhibitor denifenstat. He notes ongoing work on new classes and combination therapies.…

Surfing the MASH Tsunami

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S6 - E4.2 - Newsmaker: Fatty Liver Alliance Founder Mike Betel Discusses the Increased Visibility of Patient Advocates 31:16

4 weeks 전31:16

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31:16

This weekend's Newsmaker, Fatty Liver Alliance Founder Mike Betel, joins Roger Green to discuss the wide range of conferences where he has been invited to speak or sit on a panel this year. Specifically, he shares his belief on what this says about interest in MASLD and describes the messages he delivers at the conferences he attends. The interview starts with Roger asking about the benefits societies and the broader community get from having Mike at these programs. As he puts it, "I feel quite fortunate that I get to be, as you've shared before, the one sitting in the front row center, paying very close attention to every word that the speakers are saying so that I can share it back as it's happening." The posts he sends back from these meetings are well-received, with many reaching a 30% engagement rate and some exceeding 50%. He has been struck by the breadth of the organizations seeking to learn more about the liver and MASLD. The conference that struck him most in the last six months was the American Diabetes Association meeting, where only two MASLD KOLs spoke. Still, there was tremendous interest in MASLD throughout the conference. His key takeaway from the new conferences he attends, many of which are about diabetes or obesity, is how important it is for physicians to be sensitive in the language they use and, generally, the level of interest/empathy they show their patients. He believes this will be particularly important for front-line treaters, many of whom must fit this new, more open approach into an 8-minute visit. Mike's most important message is about "tailored therapy," therapeutic approaches sensitive not only to the patient's disease but also their life circumstances. An example he gives: taking 10,000 steps per day may not be feasible for a person living with obesity who is starting therapy, so why make that number the goal? Mike's final message to patients is to ask lots of questions, particularly about the comorbidities or test results that might suggest potential for future problems.…

Surfing the MASH Tsunami

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S6 - E4.1 - MASLD Drugs, SLD Spectrum Insights Suggest Bright Future 20:58

4 weeks 전20:58

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20:58

This conversation is the concluding segment of SurfingMASH's coverage of the AASLD Emerging Trends Conference on the SLD Spectrum diseases: MASLD, MetALD and ALD. In addition to co-hosts Louise Campbell and Roger Green, panelists include EASL Secretary General Aleksander Krag, hepatologist Alex Lalos and Jenn Leigh Jones, Founder of the Society for Sober Livers Survival patient advocacy group. The conversation starts with Roger questioning whether it is a good or bad idea to conduct separate studies on medicines' effect on MetALD patients. He notes Anna-Mae Diehl's presentation at the Conference, which suggested that regardless of organ, all cell senescence and death results from iron overload, and asks whether we should be studying this phenomenon. Aleksander agrees that important questions around iron exist and should be addressed in future research. He places this issue in context by noting that after decades of failed drug trials, SLD research has produced a string of exciting successes using different modes of action. The group turns to discuss cirrhosis, based on recent presentations from Akero Therapeutics for its agent efruxifermin. Alex notes that his quick read of slides revealed that some of the cirrhosis patients had fairly advanced disease. He expresses a high level of enthusiasm that the prospective MASLD therapies discussed in this meeting will be the third major advance during his career in medicine. Roger asks the group two closing questions: one lesson each panelist is taking from the meeting and one message they would like to share with listeners. The group members all land in a similar place: there is a spectrum running from MASLD through MetALD to ALD and we are learning how their commonalities and differences are the keys to developing better treatments and guidelines.…

Surfing the MASH Tsunami

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S6 - E4 - Reasons for optimism in MASLD drug development and patient advocacy 1:12:42

5 weeks 전1:12:42

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1:12:42

00:00:00 - Surf's Up: Season 6 Episode 4 Surfing the MASH Tsunami concludes its coverage of the AASLD Emerging Trends Conference on MASLD, MetALD and ALD. This week, the panelists focus on pivotal messages that attendees took away from the conference and what messages they would like to share with listeners. Our newsmaker, Fatty Liver Alliance and CEO Mike Betel, discusses the lessons he has taken from being invited to a far wider swath of conferences this year and shares the messages he delivers to these new audiences. Finally, our expert, hepatology research and key opinion leader Mazen Noureddin, discusses recent advances in drug development, focusing on agents in Phase 3 trials. 00:04:24 - Introduction Host Roger Green briefly describes this episode's three sections and one key lesson from each. 00:06:03 - Roundtable: Highlights from the AASLD Emerging Trends Conference, Part 4 This is the concluding portion of our Emerging Trends Conference Roundtable. The group focuses on key lessons they have learned and messages they would like listeners to take from this conversation. The pivotal idea is that SLD is a spectrum running from MASLD through MetALD to ALD. Researchers and treaters will all do best in developing and implementing therapies and guidelines with this thought in mind. Aleksander Krag stresses this idea and notes that, with several different classes of drugs demonstrating positive impact, it will be an exciting decade ahead as we learn how to apply these drugs along the spectrum. Jenn Jones and Alex Lalos note the importance of identifying MetALD, although Jenn noted that it does not seem wise to conduct trials solely with MetALD patients at this time. 00:22:04 - Newsmaker: Mike Betel on the Increased Visibility of Patient Advocates This week's newsmaker, Mike Betel, has experienced a significant increase in the number of conferences at which he is invited to speak or appear on a panel. This discussion centers around the reasons Mike believes this is happening and the message(s) he delivers. To Mike, his most important contribution lies in the amount of information he sends back from each event, many of which surpass 30% download rates (and some even hit 50%). He discusses his value in diabetes, endocrinology and obesity meetings, where he brings a "liver" perspective and co-education opportunity to these events. The entire experience has taught him about the need not to stigmatize patients and reinforced his belief in the importance of tailoring care to patients' needs and personalities. 00:49:28 - Expert: Mazen Noureddin on the Exciting MASLD Drug Development Environment Hepatologist and Key Opinion Leader Mazen Noureddin joins Roger to discuss major advances in drug development over the past year. He covers a range of different drug classes, focusing on stages of development and the range of options within each class. Specifically, he discusses the FGF-21 agents, the range of patients for whom they might be appropriate, how efruxifermin's 96-week results may make the idea of "induction therapy" less appropriate, and the exciting early data on cirrhosis patients. He provides some detail on the various incretin agonist options, why hepatologists are particularly excited about combinations that include a glucagon agent, and what kinds of results we might expect in upcoming trials. He goes on to discuss the pan-PPAR lanifibranor, the FASN inhibitor denifenstat, and notes ongoing work on new classes and combination therapies. In general, he paints, I think, not a rosy, but an extremely optimistic picture of what the future will be for patients who need to be treated for fatty liver. 01:09:38 - Business Report Roger discusses the next Roundtable and provides some details on SurfingMASH's coverage of the upcoming EASL Congress.…

Surfing the MASH Tsunami

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S6 - E3.3 - Expert: GLI's Jeff McIntyre discusses implications of FDA job cuts on MASH drugs 31:31

5 weeks 전31:31

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31:31

This week's Expert is Jeff McIntyre, Vice President, Liver Programs at the Global Liver Institute. His major topic is how recent high-level FDA job cuts might affect MASH drug and diagnostics development. He also shares reactions to FibroSIGHT, HistoIndex's new digital pathology service for clinical practice. Highlight: Recent job cuts at the FDA will produce chaos in government and slow response to any emerging crises. Second Highlight: Patient self-advocacy becomes even more important in this environment. The conversation takes place on April 1, which lends context to Jeff's opening comment about the rate and nature of change in Washington, DC. He and Roger quickly focus on high-level job cuts at the FDA. Jeff believes that the clearest outcome from these changes is that the government will be less able to respond promptly and in a medically appropriate manner to future health crises. Jeff agrees with former FDA Commissioner Rob Califf's comment that the FDA as we know it "is dead," and that we have little idea what the future holds. A slower-moving, more chaotic government with a Secretary of HHS who minimizes pharmacotherapies for alternative therapies presents a challenge for all SLD patients. Jeff states that patients need to become more vigilant self-advocates (even more than they are today). He also identifies patient advocacy organizations like GLI as a place patients can go to seek the guidance and support they need from patient advocates. Finally, the conversation turns to discuss FibroSIGHT. Jeff describes FibroSIGHT as "exactly where we should be and should not be at the same time," a technology that takes a significant step forward in understanding and patient support, but one that ties us to biopsy as a standard for clinical care. Jeff and Roger agree this issue will play out over the coming years.…

Surfing the MASH Tsunami

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S6 E3.2 - Newsmakers: FibroSIGHT™ Brings Clinical Trial Analytics to the Clinic 28:57

5 weeks 전28:57

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28:57

This week's newsmaker, Yukti Choudhury, Director of Clinical Development at HistoIndex, joins Roger Green to discuss FibroSIGHT, a new HistoIndex service that allows clinicians to use HistoIndex's Second Harmonic Generation (SHG) technology and analytics to determine specific CRN fibrosis level for patients with inconclusive NIT results. One reason FibroSIGHT is worthy of attention: This is the first time an in-depth analysis of clinical trial biopsy results is being placed at the service of clinical treatment. Another reason: Yukti states that demand for this technique could equal 163,000 cases this year, rising to one million by 2028. The interview starts with Yukti sharing information on her own academic and commercial background and how she came to this role. She describes FibroSIGHT, a service that will provide a highly accurate CRN fibrosis level for patients whose NIT results suggest no clear or consistent finding. Yukti provides practical cues on ordering the test and its reimbursement. Roger shares his long-standing respect for SHG and the clarity it produces. He notes the economic benefit of determining whether a patient has F2 fibrosis, which is indicated for pharmacotherapy, vs.F1, which is not indicated. He sees clear benefit in this analysis. Roger goes on to express concern that any option requiring more biopsies will reduce the number of patients treated, particularly if having this tool encourages payers to require a biopsy as a prerequisite to treatment. He asks whether, over time, HistoIndex might be able to develop a companion analytic to improve these estimates without requiring biopsy.…

Surfing the MASH Tsunami

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S6- E3.1 - Roundtable: Spotting Tomorrow’s Trends in Today's MASLD Studies 15:02

5 weeks 전15:02

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15:02

Surfing the MASH Tsunami continues its coverage of the AASLD Emerging Trends Conference on MASLD, MetALD and ALD. This week, the panelists focus on what studies on bariatric surgery and drugs in development can tell us about future treatment and explore some clinical trial questions. Guest Surfers include Professor Aleksander Krag of the University of Southern Denmark, the current Secretary-General of EALS, hepatologist Alexander Lalos of Robert Wood Johnson hospital, and Jenn Leigh Jones, founder of the Society for Sober Livers Survival, now part of the Fatty Liver Foundation. Aleksander Krag starts by discussing a presentation on what we can learn from bariatric surgery in terms of fibrosis reduction and why pharmacotherapies work (or not). He envisions a day where we have multiple treatment options and understanding how each works for specific types of patients, leading to robust, cost-effective, patient-specific treatment algorithms. Alex Lalos describes how presentations on FGF-21s in advanced fibrosis and cirrhosis have whetted his appetite and Jenn Jones asks questions regarding ALD patient trial selection and assignment and clinical endpoints for cirrhosis trials.…

Surfing the MASH Tsunami

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S6 - E3 - Drugs and Diagnostics Evolve as the FDA Devolves 1:12:31

6 weeks 전1:12:31

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1:12:31

00:00:00 - Surf's Up: Season 6 Episode 3 Surfing the MASH Tsunami continues its coverage of the AASLD Emerging Trends Conference on MASLD, MetALD and ALD. This week, the panelists focus on what studies on bariatric surgery and drugs in development can tell us about future treatment and explore some clinical trial questions. Our newsmaker, HistoIndex Director of Clinical Development Yukti Choudhury, introduces us to FibroSIGHT, which provides clinicians with highly precise biopsy analysis. Finally, our expert, Global Liver Institute Vice President, Liver Programs Jeff McIntyre, discusses the implications of recent US government job cuts on future MASH treatment options and patient care. 00:04:35 - Introduction Host Roger Green briefly describes this episode's three sections and one key lesson from each. 00:05:45 - Roundtable: Highlights from the AASLD Emerging Trends Conference, Part 3 This portion of our Emerging Trends Conference Roundtable looks at how therapy might evolve over time. Aleksander Krag starts by discussing a presentation on what we can learn from bariatric surgery in terms of fibrosis reduction and why pharmacotherapies work (or not). He envisions a day where we have multiple treatment options and understanding how each works for specific types of patients, leading to robust, cost-effective, patient-specific treatment algorithms. Alex Lalos describes how presentations on FGF-21s in advanced fibrosis and cirrhosis have whetted his appetite and Jenn Jones asks questions regarding ALD patient trial selection and assignment and clinical endpoints for cirrhosis trials. 00:16:55 - Newsmakers: FibroSIGHT Brings Clinical Trial Analytics to Clinical Practice Use of Biopsy Yukti Choudhury, Director of Clinical Development at HistoIndex, joins Roger Green to discuss FibroSIGHT, a new HistoIndex service that allows clinicians to use HistoIndex's Second Harmonic Generation (SHG) technology to determine specific CRN fibrosis level for patients with inconclusive NIT results. Yukti states that demand for this technique could equal 163,000 cases this year and rising to one million by 2028. She provides practical cues on ordering the test and its reimbursement. Roger shares his long-standing respect for SHG and the clarity it produces. He notes the economic benefit of determining whether a patient has F2 fibrosis, which is indicated for pharmacotherapy, vs.F1, which is not indicated. He sees clear benefit, but expresses concern that any option requiring more biopsies will reduce the number of patients treated. 00:41:49 - Patient Advocate and Policy Expert Jeff McIntyre Discusses the Implications of FA/NIH Job Cuts on MASLD Patient Care Global Liver Institute Vice President, Liver Programs Jeff McIntyre joins Roger to discuss the April 1 job reductions at the FDA, explore implications for the entire MASLD community, and to ask what patients can and should do. Jeff and Roger note that the job changes will create significant uncertainty and probably reduce the government's ability to respond to future health crises. Jeff notes former FDA Commissioner Rob Califf's comment that the FDA as we know it "is dead," and that we have little idea what the future holds. According to Jeff, patients need to become even more vigilant self-advocates and also seek the guidance and support they need from patient advocacies. Finally, the conversation turns to discuss FibroSIGHT. Jeff describes FibroSIGHT as "exactly where we should be and should not be at the same time," a technology that takes a large step forward in understanding and patient support, but one that ties us to biopsy as a standard for clinical care. Jeff and Roger agree this issue will play out over the coming years. 01:09:18 - Business Report Roger thanks listeners quoting a letter from one of them, and describes the next round of episodes.…

Surfing the MASH Tsunami

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S6 - E2 - MetALD Epidemiology, MASLD Mortality and a PCP "Unicorn" 1:11:36

7 weeks 전1:11:36

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리스트

1:11:36

00:00:00 - Surf's Up: Season 6 Episode 2 Surfing the MASH Tsunami continues its coverage of the AASLD Emerging Trends Conference on MASLD, MetALD and ALD. This week, the panelists focus on disease epidemiology and what it can teach us about the relative importance of alcohol and diet on disease progression. Our newsmaker, hepatology KOL and frequent Surfer Hannes Hagstrom, discusses what a recent paper demonstrates about the impact of MASLD on 15-year mortality and cause of death and how this information can improve patient care. Finally, our Expert, Shelbyville, Indiana internist Emily Ann Andeya, discusses her path from practicing internal medicine to focus on liver health (HINT: the common theme is insulin resistance). 00:04:40 - Introduction Host Roger Green briefly describes this episode's three sections and one key lesson from each. 00:05:49 - Roundtable: Highlights from the AASLD Emerging Trends Conference, Part 2 The second portion of our Roundtable focuses on relative impact of alcohol and diet on disease progression and overall mortality and morbidity. It starts with Aleksander Krag sharing the highlights of his epidemiology presentation at the Emerging Trends Conference. Dr. Krag points out that while the vast majority of SLD patient live with MASLD, the vast majority of hospitalized patients and those living with late-stage cirrhosis live with ALD. Similarly, for the average patient, living with MetALD is more lethal than living with MASLD. Aleksander points out another challenge in defining where a patient lives on the ALD -> MetALD -> MASLD spectrum: patients' level of alcohol consumption is likely to change over time and many ALD or MetALD cirrhosis patients stop drinking altogether. The rest of this section considers the importance of stigma in correctly classifying patients and why genetics may become key to a message that minimizes patient stigma. 00:25:50 - Newsmaker: Hepatology Researcher and KOL Hannes Hagstrom of the Karolinska Institute joins Roger to discuss cause-specific mortality in Swedish MASLD patients On March 24, the Journal of Hepatology posted a paper titled Cause-specific mortality in 13,099 patients with metabolic dysfunction-associated steatotic liver disease in Sweden . Co-author Hannes Hagstrom joins Roger to discuss the paper's key findings and implications for care. The key finding: living with MASLD leads to a significant increase in 15-year mortality. The most frequent cause of death among MASLD patients is cardiovascular disease, but the greatest increases in relative risk were due to HCC (HR ~ 35) and extra-hepatic cancers (HR ~ 26). Hannes points out that these results can serve as the beginning of a process where physicians can compute the risk at which individual patients place themselves through diet or alcohol patterns, which can aid patient understanding of the disease. 00:44:22 - Experts: Internist Emily Ann Andeya discusses how she developed the commitment to treating liver disease that made her a "unicorn" in the words of one AASLD panelist and also brought her to attend the Emerging Trends Conference last month Roger first met Emily Ann Andeya when she asked a question at a session of last fall's The Liver Meeting, and again at the Emerging Trends Conference, where Emily and her colleagues were likely the only primary care physicians in the room. Emily describes the path by which she went from wanting to be a cardiologist during medical school in the Philippines through years of nursing in the US to primary care practice and, how, focus on the liver as a key to overall metabolic health. Listen as Emily explains the importance of understanding insulin resistance in her transition, and how her vision affects the way she and her colleagues practice, the goals they set, and the exceptional levels of care they achieve. 01:08:56 Business Report…

Surfing the MASH Tsunami

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S6 - E1: Two Multispecialty February Conferences and Europe Prepares for Resmetirom 1:13:24

8 weeks 전1:13:24

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리스트

1:13:24

00:00:00 - Surf's Up! Season 6 Episode 1 SurfingMASH kicks off our sixth season in our new format, with three major elements to each episode. This week's Roundtable and Newsmakers segments focused on two recent conferences that took a multispecialty perspective on the range of medical and psychological issues affecting steatotic liver disease (a new concept specialty: steatology.") Our Expert this week is our co-host Jörn Schattenberg, discussing the educational and conceptual challenges of readying Europe for the EMA approval of resmetirom later this year. 00:03:58 - Introductions and Groundbreakers Host Roger Green describes the new v2.0 format. He introduces the guests for this month's Roundtable discussion of the AASLD Emerging Trends conference: co-host Louise Campbell, hepatology KOL and EASL Secretary-General Aleksander Krag, Alcohol Use Disorder and Alcohol Liver Disease patient advocate and Sober Livers patient support organization co-founder Jenn Leigh Jones, and clinical hepatology Alexander Lalos. 00:15:46 - Roundtable: Highlights from the AASLD Emerging Trends Conference, Part 1 The first portion of our Roundtable focuses on the emerging recognition throughout hepatology that MASLD, MetALD and ALD are best described as a disease spectrum, rather than discreet diseases. This has implications for the medical specialties involved in treatment and the entire way we look at this diseases. 00:32:35 - Newsmakers: Arizona Liver Health Institute Chief Medical Officer Naim Alkhouri and Fatty Liver Alliance Founder Mike Betel Discuss the 2025 Deser Liver Conference Now in its fourth year, the Arizona Liver Health Institute's Desert Liver Conference has become a major multispecialty event on the Winter conference agenda. Arizona Liver Health Chief Medical Officer and hepatology KOL Naim Akhouri and patient advocate and Fatty Liver Alliance Founder Mike Betel join Roger Green to discuss the conference, including what makes it unique. Listen to Naim introduce a new description of the science of SLD. 00:55:21 - Experts: SurfingMASH co-host and hepatology KOL Jörn Schattenberg joins Roger Green to discuss how Europe is preparing for the launch of resmetirom and his own focus on this issue Our third co-host, Jörn Schattenberg, could not join the February roundtable discussion. Here, he joins Roger to update listeners on his activities over the past six months. Most of the discussion centers around the necessary steps for Europe to prepare for the launch of resmetirom (anticipated to occur later this year), particularly given that the overall environment is more "siloed." 01:11;15 - Wrap-up: Roger presents "the shortest Business Report ever" Roger discusses one continuing feature of Business Reports in the future from today and leaves all his other topics for next week.…