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CPD

Screening for Nonalcoholic Steatohepatitis in the Patient With Metabolic Disorders

  • Authors: Ali Canbay, MD
  • CPD Released: 1/31/2022; Reviewed and Renewed: 2/1/2023
  • Valid for credit through: 2/1/2024, 11:59 PM EST
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  • Credits Available

    Non-US Physicians - maximum of 0.25 CPD

    You Are Eligible For

    • Letter of Completion

Target Audience and Goal Statement

This educational activity is intended for non-US and non-UK hepatologists and other specialists/healthcare practitioners (endocrinologists/gastroenterologists/primary care physicians) involved or interested in metabolic liver diseases such as nonalcoholic steatohepatitis (NASH).

The goal of this activity is to improve the understanding of NASH as a highly prevalent metabolic disease with serious complications for which novel noninvasive diagnostic tools and therapies are now emerging.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Guideline recommendation consensus for screening individuals at risk of NASH
  • Have greater competence related to
    • Implementation of the latest guidelines for identification and risk stratification of patients with NASH by using noninvasive tests


Disclosures

WebMD Global requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships with ineligible companies.


Faculty

  • Ali Canbay, MD

    Professor of Medicine
    Ruhr-Universität Bochum
    Department of Medicine
    Universitätsklinikum Knappschaftskrankenhaus
    Bochum, Germany

    Disclosures

    Disclosure: Ali Canbay, MD, has the following relevant financial relationships: Advisor or consultant for: Boehringer Ingelheim; Gilead
    Speaker or a member of a speakers bureau for: Alexion; Falk; Intercept; Merz; Takeda

Steering Committee

  • Philip Newsome, PhD, FRCPE

    Professor of Experimental Hepatology and Honorary Consultant Hepatologist
    Director of Research and Knowledge Transfer
    Director of Centre for Liver and Gastrointestinal Research
    Institute of Immunology and Immunotherapy
    College of Medical & Dental Sciences
    University of Birmingham
    Birmingham, United Kingdom

    Disclosures

    Disclosure: Philip Newsome, PhD, FRCPE, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Boehringer Ingelheim; Bristol Myers Squibb; Gilead; Novo Nordisk; Pfizer Inc.; Poxel
    Served as a speaker or a member of a speakers bureau for: Gilead; Novo Nordisk

  • Quentin M. Anstee, BSC (Hons), MD, BS, PhD, MRCP(UK), FRCP

    Professor of Experimental Hepatology & Honorary Consultant Hepatologist
    Translations & Clinical Research Institute Faculty of Medical Sciences
    Newcastle University
    Newcastle upon Tyne, United Kingdom

    Disclosures

    Disclosure: Quentin M. Anstee, BSC (Hons), MD, BS, PhD, MRCP (UK), FRCP, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: 89Bio; Abbott Laboratories; Acuitas Medical; Allergan/Tobira; Altimmune; AstraZeneca; Axcella; Blade; Bristol Myers Squibb; BNN Cardio; Celgene; Cirius; Clinical Care Options; CymaBay; EcoRl; E3Bio; Eli Lilly & Company Ltd.; Falk; Fishawack; Galmed; Genentech; Genfit SA; Gilead; Grünenthal; Histolndex; lndalo Therapeutics; Imperial Innovations; lntegritas Communications; Intercept Pharma Europe Ltd.; lnventiva; IQVIA; Janssen; Kenes; Madrigal; Medlmmune; Metacrine; NewGene; NGMBio; NorthSea Therapeutics; Novartis; Novo Nordisk A/S; Pfizer Inc.; Poxel; ProSciento; Raptor Pharma; Servier; Terns; Viking Therapeutics
    Served as a speaker or a member of a speakers bureau for: Abbott Laboratories; Allergan/Tobira; Bristol Myers Squibb; Clinical Care Options; Falk; Fishawack; Genfit SA; Gilead; lntegritas Communications; Kenes
    Received grants for clinical research from: AbbVie; Antaros Medical; Allergan/Tobira; AstraZeneca; Bristol Myers Squibb; Boehringer lngelheim International GMBH; Echosens; Ellegaard Gottingen Minipigs AS; Eli Lilly & Company Ltd.; Exalenz Bioscience Ltd.*; Genfit SA*; Glympse Bio; GlaxoSmithKline; Histolndex; Intercept Pharma Europe Ltd.; iXscient Ltd.; Nordic Bioscience; Novartis Pharma AG; Novo Nordisk A/S; One Way Liver Genomics SL; Perspectum Diagnostics; Pfizer Inc.; Resoundant; Sanofi-Aventis Deutschland GMBH; SomaLogic Inc.; Takeda Pharmaceuticals International SA

  • Elisabetta Bugianesi, MD, PhD

    Professor
    University of Turin
    Turin, Italy

    Disclosures

    Disclosure: Elisabetta Bugianesi, MD, PhD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Bristol Myers Squibb; Boehringer Ingelheim; Gilead; Intercept; Novo Nordisk
    Served as a speaker or a member of a speakers bureau for: Gilead; Intercept
    Received grants for clinical research from: Gilead

  • Rohit Loomba, MD

    Professor of Medicine
    Adjunct Professor, Division of Epidemiology
    Director of Hepatology Division of Gastroenterology
    University of California San Diego
    Director
    NAFLD Research Center
    San Diego, California, United States

    Disclosures

    Disclosure: Rohit Loomba, MD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Anylam/Regeneron; Amgen; Arrowhead Pharmaceuticals; AstraZeneca; Bristol Myers Squibb; Eli Lilly & Company Ltd.; Galmed; Gilead; Intercept; Ionis; Janssen Inc.; Merck; Metacrine Inc.; NGM Biopharmaceuticals
    Other: Co-founder of Liponexus

  • Arun Sanyal, MD

    Professor
    Department of Internal Medicine
    Division of Gastroenterology, Hepatology and Nutrition
    Virginia Commonwealth University School of Medicine
    Richmond, Virginia, United States

    Disclosures

    Disclosure: Arun Sanyal, MD, has disclosed the following relevant financial relationships:
    Served as a speaker or a member of a speakers bureau for: Bristol Myers Squibb; Boehringer Ingelheim; Celgene; Gilead; Intercept; Inventiva; Madrigal; Mallinckrodt; Merck; NGM; Novo Nordisk; Eli Lilly & Company Ltd.; Pfizer Inc.; Viking; Zydus
    Received grants for clinical research from: Durect; Exhalenz; Genfit; HemoShear Therapeutics; Indalo Therapeutics
    Owns stock, stock options, or bonds from: Sanyal Bio

  • Lawrence Serfaty, MD

    Professor of Hepatology
    Chief of the Liver Diseases Department
    Hautepierre Hospital
    University of Strasbourg
    Strasbourg, France

    Disclosures

    Disclosure: Lawrence Serfaty, MD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Alnylam Pharmaceuticals; Intercept; Novartis; Novo Nordisk; Pfizer Inc.; Theratechnologies Inc.
    Served as a speaker or a member of a speakers bureau for: Gilead; Intercept; Novartis/Sandoz
    Received grants for clinical research from: Gilead

Editor

  • Walid Amara, MD

    Medical Education Director, WebMD Global, LLC

    Disclosures

    Disclosure: Walid Amara, MD, has disclosed no relevant financial relationships.

Compliance Reviewer

  • Leigh Schmidt, MSN, RN, CMSRN, CNE, CHCP

    Associate Director, Accreditation and Compliance

    Disclosures

    Disclosure:  Leigh Schmidt, MSN, RN, CMSRN, CNE, CHCP has no relevant financial relationships


Accreditation Statements

    For Physicians

  • The Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom (FPM) has reviewed and approved the content of this educational activity and allocated it 0.25 continuing professional development credits (CPD).

    Contact WebMD Global

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]


Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information about your eligibility to claim credit, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent participating in the activity. To successfully earn credit, participants must complete the activity online during the credit eligibility period that is noted on the title page.

Follow these steps to claim a credit certificate for completing this activity:

  1. Read the information provided on the title page regarding the target audience, learning objectives, and author disclosures, read and study the activity content and then complete the post-test questions. If you earn a passing score on the post-test and we have determined based on your registration profile that you may be eligible to claim CPD credit for completing this activity, we will issue you a CPD credit certificate.
  2. Once your CPD credit certificate has been issued, you may view and print the certificate from your CME/CE Tracker. CPD credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of the Medscape Education homepage.

We encourage you to complete an Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

*The credit that you receive is based on your user profile.

CPD

Screening for Nonalcoholic Steatohepatitis in the Patient With Metabolic Disorders

Authors: Ali Canbay, MDFaculty and Disclosures

CPD Released: 1/31/2022; Reviewed and Renewed: 2/1/2023

Valid for credit through: 2/1/2024, 11:59 PM EST

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Stacia is a 49-year-old hair stylist. She is married with 2 children.

She has obesity and is treated for high blood pressure, dyslipidemia, and type 2 diabetes.

She comes to see her physician because she feels tired and bloated.

Case Study, Part 1

Patient: I’m used to being on the go. Lots of energy. Loads of plans. But as of late, I just don’t have it in me. I’m exhausted. Literally exhausted. All the time.  

Clinician: What do you think has changed?

Patient: I haven’t a clue. I’m sure my diabetes doesn’t help, but I’m not doing anything different. It doesn’t seem to matter what I eat -- it just makes me feel tired and bloated. And the indigestion is awful. I’m belching all the time -- you’d think I’d just chugged a pint, but I don’t even drink.

Lucky my husband thinks it’s funny -- (says jokingly) could be grounds for divorce, otherwise.

Clinician: Do you get a burning sensation in the back of your throat?

Patient: Yes, a bit. My throat can be sore. And, honestly, my whole digestive system feels a bit off. I have the bloating and sometimes this pain right here. (places hands just under right rib)

Clinician: Can you describe the pain? Is it constant or does it come and go?

Patient: It’s more of a dull constant ache.

Clinician: Are you taking anything over the counter?

Patient: I’ve tried antacids and I’ll take paracetamol on occasion. Otherwise, I only take what you prescribed for my cholesterol and blood pressure. And the metformin, of course.

Clinician: Are you still in the walking group?

Patient: No. I stopped during COVID and haven’t gone back. I would like to eventually, but I don’t have the time right now. (pause) Actually, that’s not true -- I just don’t have the energy.

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