MASH (formerly known as NASH) Research Updates in 2020

Megan M. MacBride, PhD
Tuesday, March 10th, 2020
International Liver Congress™ 2019 Statistics.
Source: EASL

Metabolic dysfunction-associated steatohepatitis (MASH) continues to be a hot topic in metabolic disease research. The MASH research field gathers twice a year at major conferences:

What insights were shared at The Liver Meeting 2019 and what do we have to look forward to at the upcoming International Liver Congress?

AASLD — The Liver Meeting, November 2019

A key takeaway from The Liver Meeting last fall was that although there are therapeutics moving closer to FDA approval, the drug discovery race is nowhere near over. metabolic dysfunction-associated steatotic liver disease (MASLD) and MASH are complex diseases which are not well understood, and much remains to be elucidated in terms of the basic biology.

Preclinical MASLD/MASH research will continue to be robust for the foreseeable future as researchers explore mechanistic pathways and associations such as inflammation, autophagy, cholesterol metabolism and lipotoxicity, exosomes, microbiome, and more. Diet-induced MASH models will continue to be used widely for this type of research as well as for screening therapeutic candidates.

Non-Invasive Diagnostics for MASH

Non-invasive diagnostics were of high interest with many presentations focusing on validating these methods. The gold standard for diagnosing MASH is still the liver biopsy, but significant progress has been made towards identifying alternative diagnostic methods. These alternative methods are important both for identifying at-risk patients as well as facilitating clinical trials for MASH therapeutics.

Increasing International Engagement at AASLD

MASH is a global problem. Although the majority of meeting attendees were from North America, with Europe coming in second, the third most populous category was attendees from East and Southeast Asia, with nearly 14% of attendees from this region. This engagement by Asian researchers reflects the recognition of MASH as a serious public health threat in that region.

AASLD 2019 Attendees by Region

MASH Clinical Trial Results

Results from a number of clinical trials were reported at the meeting. Interim results for a phase 2 study of tropifexor were positive, with the drug leading to reductions of alanine aminotransferase (ALT), hepatic fat fraction and body weight relative to placebo controls. Similarly, a phase 2 study of saroglitazar demonstrated that it reduced ALT and hepatic steatosis, though body weight was not significantly changed compared to placebo.

In contrast, disappointing results were reported for emricasan which did not meet predefined study endpoints. Compared to starting fibrosis scores for each patient, a higher proportion of patients on emricasan ended the study with worsened fibrosis relative to patients in the placebo arm.

AASLD — The Liver Meeting Summary Slide Decks

AASLD pulls together summary slide decks as a helpful tool to highlight the most critical information from the meeting. Check out The Best of The Liver Meeting® 2019 — MASLD/MASH for a further summary of the most important MASLD/MASH science presented at the meeting.

Upcoming Conferences: International Liver Congress 2020

This year's Liver Congress has been postponed to August 25-28 due to COVID-19 concerns. A global attendee base of ~10,000 is expected and the preliminary scientific program features a number of sessions on MASLD/MASH, from basic research through the clinic.

The meeting is sure to bring surprises and will be closely watched by analysts focusing on the MASH therapeutics market.

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