Saturday, May 16, 2015

DDW 2015 - Experts to describe prospects for hepatic fibrosis therapy

Experts to describe prospects for hepatic fibrosis therapy
Posted By: DDW Daily News on: May 16, 2015
In: AASLD, By Society, DDW Daily News, Saturday, May 16

Researchers are gaining insights into the mechanisms underlying hepatic fibrosis, creating the potential for new, antifibrotic treatments in the coming years.

“It’s an exciting time because decades of solid, basic biologic studies are now translating into a clearer understanding of the disease and how to attack it therapeutically,” said Scott L. Friedman, MD, FAASLD, dean for therapeutic discovery at the Icahn School of Medicine at Mount Sinai in New York, NY.

Dr. Friedman and Nezam H. Afdhal, MD, FAASLD, director of hepatology at Beth Israel Deaconess Medical Center and professor of medicine at Harvard Medical School, Boston, will moderate Sunday’s AASLD Clinical Symposium Prospects for Therapy of Hepatic Fibrosis.

The session will review how recent insights into hepatic fibrosis pathogenesis are leading to novel therapeutic approaches. The presenters will also examine emerging technologies that will enhance clinicians’ ability to quantify fibrosis without performing a liver biopsy.

Hepatic fibrosis has received increased research attention at least in part because of advancements in the treatment of hepatitis C and B. Dr. Friedman said the growing problem of nonalcoholic steatohepatitis (NASH) has also increased interest in hepatic fibrosis.

“There is a real sense of urgency that we need to understand not only the pathogenesis of NASH, but also the fibrosis that develops because of NASH,” he said. “With that comes a greater emphasis on partnering with FDA and regulatory agencies to develop new ways to test new drugs and to get them to patients faster.”

There are no drugs currently on the market to treat hepatic fibrosis, Dr. Friedman said, but recent advances in clarifying hepatic stellate cell biology and the mechanisms of fibrosis progression and regression have raised the realistic expectation for new antifibrotic treatments.

“The old tried-and-true cellular target — the hepatic stellate cell, the key fibrogenic cell in the liver — remains quite relevant and at the center of therapeutic efforts,” Dr. Friedman said. “But in addition, we have layered on to that a large number of new pathways including cytokines, lipogenesis and insulin signaling that also may uncover new targets for therapy.”

The session will also include a review of non-invasive techniques now available for the diagnosis of fibrosis. “The trend is going away from liver biopsy and moving toward serological and radiological tests for fibrosis,” Dr. Afdhal said.

These tools include transient elastography and new ultrasound machines that use supersonic shear waves, he added. The accuracy of the tests, as well as the possibility of missing patients with more advanced disease, is one downside to the non-invasive approaches, Dr. Afdhal acknowledged.
During the session, he and Dr. Friedman will demonstrate how to use the tests and discuss their success rates in making the right diagnosis and avoiding misdiagnoses.

Please refer to the schedule-at-a-glance in Sunday’s issue for the time and location of this and other DDW® events.

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