Liver

27 - FibroScan Risk Assessment of Non-Alcoholic Fatty Liver Disease (FRAN Trial) in Community Specialty Care (late-breaking abstract)

Tuesday, October 9
9:50 AM - 10:00 AM
Location: Terrace Ballroom 4 (level 400)

Category: Liver
Woodie M. Zachry, III, PhD, RPh1, Guy W. Neff, MD, MBA2, David Halajko, MD1, Sarai Leiva2, Mira K. Khazanchi2
1Quantym Therapeutic Data, Bradenton, FL; 2Florida Research Institute, Lakewood Ranch, FL

Background: The detection rate of undiagnosed liver abnormalities via FibroScan has not been fully quantified. This study’s purpose is to investigate the utility of FibroScan as a screening tool for Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH).

Methods: A network of Gastroenterologists offices and endoscopy suites in Florida, USA was the setting. Two of six endoscopy suites in the network were provided with FibroScans. A convenience sample of fasting endoscopy patients was collected between 6/2017 and 1/2018. Thresholds for FibroScan result follow up were >248dB/M Controlled Attenuation Parameter (CAP) for steatosis and/or >7kPa Liver Stiffness (LS) for any fibrosis (F1-F4). Screened patients were matched 1:3 by age and sex to a sample of unscreened patients undergoing endoscopy during the same period. Patients electronic medical records were examined for diagnoses of fatty liver disease (FLD), NAFLD, NASH or other liver abnormalities (OLA) within 90 days after the endoscopy. Patients were excluded for a history of any liver-related condition. Prevalence of FLD, NAFLD, NASH and OLAs were compared by chi square with significance of p<0.05.

Results: 380 patients receiving an FibroScan (SCR) were matched to 1150 controls (CTR). Both groups were 60.5% female, similar in age (mean SCR 66.0yrs, CTR 66.6yrs) and BMI (mean SCR 27, CTR 27). Those screened had a significantly higher percentage of “Non-Hispanic” patients (SCR 96.6%, CTR 91.4%; p=0.001). Isolated high CAP (suggesting NAFLD) was present in 43.5% (n=165) of SCR patients, isolated abnormal LS in 3.7% (n=14) and both CAP and LS elevated in 9.7% (n=37) suggesting NASH. NASH was confirmed in 25 SCR patients by biopsy (n=4) and clinician follow up diagnosis (n=21), while 2 patients were diagnosed with other conditions (Alcoholic Liver Disease, NAFLD) and 10 lost to follow up. Overall there were greater incidence of diagnoses for FLD (SCR 5.3%, CTR 1.8%, p<0.001), NAFLD (SCR 4.7%, CTR 1.7% p=0.001) and NASH (SCR 6.6%, CTR 0.1%) but not OLA (SCR 0.8%, CTR 1.5%, p=0.298) in the screened vs control group.

Conclusion: FibroScan screening for FLD, NASH and NAFLD revealed significantly more cases of undiagnosed liver disease than usual care. The use of FibroScan in screening for liver issues represents a significant public health opportunity. Training for appropriate follow up diagnosis and care could maximize screening utility for NAFLD and NASH.


Disclosures:
Woodie Zachry indicated no relevant financial relationships.
Guy Neff indicated no relevant financial relationships.
David Halajko indicated no relevant financial relationships.
Sarai Leiva indicated no relevant financial relationships.
Mira Khazanchi indicated no relevant financial relationships.

Woodie Zachry

Chief Science Officer
Quantym Therapeutic Data
Bradenton, Florida

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27 - FibroScan Risk Assessment of Non-Alcoholic Fatty Liver Disease (FRAN Trial) in Community Specialty Care (late-breaking abstract)



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