NASH Research Updates in 2020

International Liver Congress™ 2019 Statistics.
Source: EASL

Nonalcoholic steatohepatitis (NASH) continues to be a hot topic in metabolic disease research. The NASH research field gathers twice a year at major conferences:

• The Liver Meeting is organized by the American Association for the Study of Liver Diseases (AASLD) in the US in the Autumn.
• International Liver Congress is organized by the European Association for the Study of the Liver (EASL) in Europe every Spring.

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. Nonalcoholic fatty liver disease (NAFLD) and NASH are complex diseases which are not well understood, and much remains to be elucidated in terms of the basic biology.

Preclinical NAFLD/NASH 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 NASH models will continue to be used widely for this type of research as well as for screening therapeutic candidates.

Non-Invasive Diagnostics for NASH

Non-invasive diagnostics were of high interest with many presentations focusing on validating these methods. The gold standard for diagnosing NASH 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 NASH therapeutics.

Increasing International Engagement at AASLD

NASH 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 NASH as a serious public health threat in that region.

NASH 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 — NAFLD/NASH for a further summary of the most important NAFLD/NASH 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 NAFLD/NASH, from basic research through the clinic.

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