MASLD is expected to grow over the next 25 years

Metabolic dysfunction-associated steatotic liver disease (MASLD) is expected to increase by 23% over the next three decades, placing a significant burden on the health care system, according to a mathematical modeling study presented this week at the American Association for the Study of Metabolic Dysfunction (MASLD). Liver Disease (AASLD) Liver Meeting in Boston.

“As diabetes and obesity rates increase, MASLD is expected to become the leading cause of liver transplants in the United States,” said lead researcher Phuc Le, PhD, MPH, of the Cleveland Clinic Lerner College. To overcome this, the Department of Medicine said in an AASLD press release.

MASLD is the new name for the condition formerly known as non-alcoholic fatty liver disease (NAFLD), and its more serious form, metabolic dysfunction-associated steatohepatitis (MASH, formerly known as non-alcoholic steatohepatitis or NASH). was known as), is a pioneer. Cause of advanced liver disease worldwide.

Linked to obesity and type 2 diabetes, fatty liver disease is increasingly being recognized as a metabolic disorder. Over time, the buildup of fat in the liver can lead to inflammation, fibrosis, cirrhosis, and liver cancer. Now that hepatitis B can be prevented with vaccines and hepatitis C can be easily cured, steatotic liver disease accounts for an increasing proportion of liver cancer cases and liver transplants. With no effective approved medical treatments, MASLD management relies on lifestyle changes such as diet, exercise, and weight loss.

His team aims to estimate the burden of MASLD among adults in the United States from 2020 to 2050 using a population-based natural history model. They developed an agent-based state transition model consisting of two components with an annual cycle. The first component simulated the US population starting in the year 2000 based on census data. The second component tracked the natural history of fatty liver disease progression from no steatosis (fat in the liver) to simple steatosis, MASH, fibrosis, cirrhosis, decompensated cirrhosis (liver failure), hepatocellular carcinoma (the most common type of liver cancer). Liver transplantation and ultimately liver-related death.

From 2000 to 2018, validation of the model showed a close match between predicted outcomes and actual observed trends in MASLD prevalence, progression to MASH, liver cancer and overall survival.

Looking ahead, the model predicted a steady increase in the prevalence of MASLD among adults, from 28% (about 72 million people) in 2020 to 34% (about 109 million) by 2050. Among people with MASLD, the proportion who progress to MAS is expected to increase from 20% to 22%. While the prevalence of MASLD is projected to remain relatively stable for people aged 18 to 29 years, it is expected to increase significantly for all other age groups.

The proportion of people with MASLD who develop cirrhosis is expected to increase from about 2% in 2020 to 3% in 2050. By that time, MASLD could lead to a substantial increase in new cases of liver cancer (from 10,400 in 2020 to 19,300 in 2050) and a large increase in the number of liver transplants (from 1,700 in 2020 to 4,200 in 2050). Furthermore, the proportion of liver-related deaths is expected to increase from 0.4% of all deaths in 2020 to 1% by 2050.

“Our model predicts a substantial clinical burden of NAFLD (MASLD) over the next three decades,” the researchers concluded. “In the absence of effective treatments, health systems must plan for a large increase in the number of HCC cases and the need for liver transplantation.”

“Liver diseases often progress silently, with symptoms appearing only in advanced stages. Increasing awareness is essential to maximize the opportunities to prevent liver complications,” said AASLD President Nora Terrault, MD, MPH. “Early detection and timely intervention can make a difference – that’s why AASLD is dedicated to equipping physicians with the knowledge and skills needed to drive better health outcomes.”

Speaking at an AASLD media briefing, Le explained, “There’s no way we’re going to be able to get out of this.” However, if obesity trends are reversed and management of MASLD and MASH improve – in particular, if effective new drugs eventually make it through the development pipeline – “the future will not be so bleak.”

Click here to read the study summary.

Click here for more news about steatotic liver disease.

Click here for more reports from The Liver Meeting.

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