Nonalcoholic Steatohepatitis Clinical Trial
Official title:
Prospective Cohort Assessing the Prevalence and Progress of Non-alcoholic Fatty Liver Disease (NAFLD)/Non-alcoholic Steatohepatitis (NASH) in Chinese
Nonalcoholic fatty liver disease (NAFLD) is a progressive liver disease ranging from simple
steatosis to cirrhosis of the liver. Nonalcoholic fatty liver (NAFL) without substantial
hepatocellular injury is thought to be relatively benign whereas nonalcoholic steatohepatitis
(NASH) is characterized by hepatocyte steatosis, ballooning, inflammation and varying degrees
of fibrosis from none to cirrhosis. NASH is strongly associated with insulin resistance and
metabolic syndrome and thus is recognized as a major public health concern as the most
prevalent liver disease.
Liver biopsy is the gold standard for a diagnosis of NASH. However, given the large
population of patients at risk for NASH, liver biopsy is not a practical method for
determining which patients may benefit from NASH therapy. Non-invasive methods to estimate
inflammation and fibrosis are in clinical use, but there remains a dichotomy between gold
standard inclusion criteria and end points that are utilized in clinical trials and real
world diagnostic methods that are more common in clinical practice.
Thus, the investigators would like to conduct an observational study to head-to-head compare
the non-invasive methods and liver biopsy in differential liver steatosis and liver biopsy in
a real-world setting. Also, by following up patients for a relatively long time (proposed 10
years), the investigators can present the natural history of disease progression.
GC-FLC is a cooperative consortium of principal investigators from academic institutions and
community-based sites treating patients with NAFLD and NASH. The investigators will leverage
the multidisciplinary expertise within this network in bio-banking, high-throughput
technologies, and biomedical informatics to give investigators the power to analyze
effectiveness data at many different levels of resolution, ranging from subsets of patients
to very large populations.
GC-FLC will use standardized data collection practices, study data monitoring, and an
comprehensive observational protocol in order to increase the efficiency and minimize costs
associated with performing clinical research while ensuring collection of detailed critical
safety and effectiveness data on prescribed NASH therapies. GC-FLC engages community and
academic practice providers as partners in the research to ensure rapid translation of
research findings into improvement in healthcare quality and outcomes and to help engage
scientists at the interfaces between clinical research and the community. Furthermore, GC-FLC
provides the opportunity to pair-comparison between liver biopsy and non-invasive biomarkers
in differential low-risk and high-risk population for treatment in real world settings.
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