My mother passed away suddenly four years ago this month after a short battle with late-stage NASH. Which is impossible, but somehow true. Just a few days before being diagnosed with NASH she was celebrating with my wife and I at a housewarming party at the Shore. A picture of her from that party occupies a prominent place on our fridge; the last picture of her before our lives were all changed forever.
It’s another promising result from one of the dozens of bio-pharmaceutical companies trying to find treatments for fatty liver disease. Viking Therapeutics announced results from an early study of NAFLD patients that exceeded expectations yesterday, sending the stock soaring 122%.
Yesterday the CDC released their 2017 Obesity data for the United States, and the data is not very encouraging. Seven states reported obesity rates at or above 35%!
I lost my mother suddenly to late-stage NASH when she was only 62 years old. The search for answers and meaning has led me to working with the American Liver Foundation and starting this blog. One thing that has become increasingly clear to me was that my mom’s decades of hypothyroidism could have been a major cause of her progression to NASH. Now, a new meta-study examining 18 years of data has concluded that those patients with primary hypothyroidism are at a 42% increased risk for developing NAFLD, the precursor to NASH. Continue reading “The Thyroid’s link to NASH”
Earlier this year I wrote about the sobering fact that up to 10% of children in the USA are estimated to be living with NAFLD, with nearly a quarter of them having progressed to NASH. It’s bad enough that millions of children are having to face this disease so early in life but the evidence is actually getting worse for pre-teen children, as research has shown that fatty liver disease progression through NASH to fibrosis and eventual liver failure is significantly accelerated versus the teen or adult population.
Ever since my Mom passed away suddenly after being diagnosed with late-stage NASH, I’ve been following the efforts of the medical community and many bio-pharma companies to develop effective treatments for the disease. Mostly, I’ve followed the efforts to develop medicine that can slow or reverse the effects of NASH, as there is a lot of attention being paid to this and some recent successful trials.
I recently attended an event with a distinguished panel of liver experts and one of the discussion points that surprised me was how effective weight-loss surgery is at treating NASH. I shouldn’t have been surprised, I suppose, because I already knew that losing a small amount of weight can lead to big improvements in NASH patients. Surgery just seemed “extreme” to me, but in fact it is by far the most effective way to achieve sustained weight loss, and has even been called one of the most effective interventions in all of health care. Continue reading “The most effective treatment for serious NASH – Surgery”
The impact of NASH is only starting to be realized. One sobering figure just released by the CDC highlights yet another trend going in the wrong direction. From 2000 to 2016, the mortality rate for liver cancer rose 43%, even while the rates for all other cancers declined.
Let’s get something out of the way up front. Dealing with weight issues is an incredibly emotional and sensitive subject, and as a society we should not focus on shaming, shunning, or victimizing the nearly half of the country that is overweight or obese. By creating a societal image of beauty and attractiveness that ostracizes over a hundred million people in the USA alone, we have done ourselves a terrible disservice.
At the same time, we cannot ignore the medical realities that are strongly correlated to being overweight. The amount of diseases and medical conditions with direct causal relationships to weight are staggering, and the evidence is strong and tested. NASH is emerging as perhaps the single largest affliction in terms of both prevalence and incidence, with estimates of over 30 million people currently living in the US with the disease, and the vast majority of them unaware that they have it until it is too late. Continue reading “The missed opportunities of the “Body Positivity” movement”
NASH is undoubtedly a complex disease, with a wide spectrum of progression and diagnosis. The good news is that if you intervene early you can stop and even reverse the serious liver damage that NASH causes. The bad news is that if it goes undetected it can cause sudden liver failure and death. Continue reading “Dazed and Confused – when severe NASH leads to Hepatic Encephalopathy”
On the heels of competitor Madrigal’s excellent trial results another small BioPharma company has released phase 2 results that sent their company stock skyrocketing. Galmed Pharmaceuticals, a small Israeli biopharmaceutical company, produced statistically significant results with a drug called Aramchol in the lowering of fat in the liver at 52 weeks. The analysis of the results was embraced by the markets, which sent the stock soaring 250%.
In one endpoint, more patients treated with 600 mg of Aramchol versus placebo achieved NASH resolution without worsening of fibrosis, at 16.7% versus 5.0% (p=0.0514), respectively, as well as NASH resolution more generally, at 19.2% compared to 7.5% (p=0.0462). In addition, the second biopsy endpoint showed a higher proportion of patients with at least a one-point improvement in fibrosis score without worsening of NASH.
We are at an exciting time for NASH treatment options with multiple companies pursuing promising candidates. People suffering from NASH will still require significant lifestyle changes but hearing about more successful trial results is a very positive step towards getting a grip on the pandemic.