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Faculty

Rohit Loomba, MD, MHSc

Professor of Medicine
Director of Hepatology
University of California at San Diego
Director, NAFLD Research Center
San Diego, California, United States

Disclosures

Rohit Loomba, MD, MHSc, has the following relevant financial relationships:
Consultant or advisor for: 89 Bio Inc; Aardvark Therapeutics; Altimmune; Amgen Inc.; Anylam/Regeneron; Arrowhead Pharmaceuticals, Inc.; AstraZeneca; Bristol Myers Squibb Company; CohBar; Eli Lilly and Company; Galmed Pharmaceuticals Ltd.; Gilead Sciences, Inc.; Glympse Bio; HighTide; INIPharma; Intercept Pharmaceuticals, Inc.; Inventiva; Ionis Pharmaceuticals; Janssen; Madrigal Pharmaceuticals, Inc.; Merck; Metacrine; NGM Biopharmaceuticals; Novartis; Novo Nordisk; Pfizer Inc.; Sagimet Biosciences; Terns Pharmaceuticals; Theratechnologies Inc.; Viking Therapeutics
Research funding from: Arrowhead Pharmaceuticals, Inc.; AstraZeneca; Boehringer Ingelheim Pharmaceuticals, Inc.; Bristol Myers Squibb Company; Eli Lilly and Company; Galectin Therapeutics; Galmed Pharmaceuticals Ltd.; Gilead Sciences, Inc.; Hanmi Pharm. Co., Ltd.; Intercept Pharmaceuticals, Inc.; Inventiva; Ionis Pharmaceuticals; Janssen; Madrigal Pharmaceuticals, Inc.; Merck; NGM Biopharmaceuticals; Novo Nordisk; Pfizer Inc.; Sonic Incytes; Terns Pharmaceuticals
Other: Co-founder of LipoNexus Inc.

Editors

Anne G. Le, PharmD

Senior Medical Education Director, Medscape, LLC

Disclosures

Anne G. Le, PharmD, has no relevant financial relationships.

Gina Montanero, PharmD, RPh

Associate Medical Writer, Medscape, LLC

Disclosures

Gina Montanero, PharmD, RPh, has no relevant financial relationships.

Compliance Reviewer

Yaisanet Oyola, MD

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Yaisanet Oyola, MD, has no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has no relevant financial relationships.

CME

How Would You Assess These Patients for Liver Fibrosis?

Authors: Rohit Loomba, MD, MHSc
CME Released: 2/28/2023
Valid for credit through: 2/28/2024

Start Activity

Credits Available

Physicians - maximum of 1.00 AMA PRA Category 1 Credit(s)™

You Are Eligible For
- Letter of Completion

Target Audience and Goal Statement

This activity is intended for gastroenterologists, diabetologists, and endocrinologists.

The goal of this activity is for learners to be better able to use appropriate NITs to assess patients for liver fibrosis.

Upon completion of this activity, participants will:

Have increased knowledge regarding the
- Appropriate NITs to use in assessing a patient for liver fibrosis
- Guideline recommendations for NAFLD screening in patients with diabetes
Have greater competence related to
- Implementing NITs for disease stratification in clinical practice

Disclosures

Faculty

Rohit Loomba, MD, MHSc

Professor of Medicine
Director of Hepatology
University of California at San Diego
Director, NAFLD Research Center
San Diego, California, United States

Disclosures

Rohit Loomba, MD, MHSc, has the following relevant financial relationships:
Consultant or advisor for: 89 Bio Inc; Aardvark Therapeutics; Altimmune; Amgen Inc.; Anylam/Regeneron; Arrowhead Pharmaceuticals, Inc.; AstraZeneca; Bristol Myers Squibb Company; CohBar; Eli Lilly and Company; Galmed Pharmaceuticals Ltd.; Gilead Sciences, Inc.; Glympse Bio; HighTide; INIPharma; Intercept Pharmaceuticals, Inc.; Inventiva; Ionis Pharmaceuticals; Janssen; Madrigal Pharmaceuticals, Inc.; Merck; Metacrine; NGM Biopharmaceuticals; Novartis; Novo Nordisk; Pfizer Inc.; Sagimet Biosciences; Terns Pharmaceuticals; Theratechnologies Inc.; Viking Therapeutics
Research funding from: Arrowhead Pharmaceuticals, Inc.; AstraZeneca; Boehringer Ingelheim Pharmaceuticals, Inc.; Bristol Myers Squibb Company; Eli Lilly and Company; Galectin Therapeutics; Galmed Pharmaceuticals Ltd.; Gilead Sciences, Inc.; Hanmi Pharm. Co., Ltd.; Intercept Pharmaceuticals, Inc.; Inventiva; Ionis Pharmaceuticals; Janssen; Madrigal Pharmaceuticals, Inc.; Merck; NGM Biopharmaceuticals; Novo Nordisk; Pfizer Inc.; Sonic Incytes; Terns Pharmaceuticals
Other: Co-founder of LipoNexus Inc.

Editors

Anne G. Le, PharmD

Senior Medical Education Director, Medscape, LLC

Disclosures

Anne G. Le, PharmD, has no relevant financial relationships.

Gina Montanero, PharmD, RPh

Associate Medical Writer, Medscape, LLC

Disclosures

Gina Montanero, PharmD, RPh, has no relevant financial relationships.

Compliance Reviewer

Yaisanet Oyola, MD

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Yaisanet Oyola, MD, has no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has no relevant financial relationships.

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For Physicians

Medscape, LLC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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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]

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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 in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

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Study the educational content online or print it out.
Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

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From Medscape Education Diabetes & Endocrinology

CME

How Would You Assess These Patients for Liver Fibrosis?

Authors: Rohit Loomba, MD, MHScFaculty and Disclosures

CME Released: 2/28/2023

Valid for credit through: 2/28/2024

processing....

References

Younossi ZM, et al. Role of noninvasive tests in clinical gastroenterology practices to identify patients with nonalcoholic steatohepatitis at high risk of adverse outcomes: expert panel recommendations. Am J Gastroenterol. 2020;116:254-262.
Cusi K, et al. American Association of Clinical Endocrinology clinical practice guideline for the diagnosis and management of nonalcoholic fatty liver disease in primary care and endocrinology clinical settings: co-sponsored by the American Association for the Study of Liver Diseases (AASLD). Endocr Pract. 2022;28:528-562.
Loomba R, et al. Mechanisms and disease consequences of nonalcoholic fatty liver disease. Cell. 2021;184:2537-2564.
Chalasani N, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67:328-357.
Caussy C, et al. The relationship between type 2 diabetes, NAFLD, and cardiovascular risk. Curr Diab Rep. 2021;21:15.
Simon TG, et al. Cancer risk in patients with biopsy-confirmed nonalcoholic fatty liver disease: a population-based cohort study. Hepatology. 2021;74:2410-2423.
Rinella ME, et al. AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023. doi: 10.1097/HEP.0000000000000323. [Epub ahead of print]
Yoshitaka H, et al. Nonoverweight nonalcoholic fatty liver disease and incident cardiovascular disease: a post hoc analysis of a cohort study. Medicine (Baltimore). 2017;96:e6712.
Dulai PS, et al. Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: systematic review and meta-analysis. Hepatology. 2017;65:1557-1565.
Anstee QM, et al. Impact of non-invasive biomarkers on hepatology practice: past, present and future. J Hepatol. 2022;76:1362-1378.
Llop E, et al. High liver stiffness values by transient elastography related to metabolic syndrome and harmful alcohol use in a large Spanish cohort. United European Gastroenterol J. 2021;9:892-902.
Browning JD, et al. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology. 2004;40:1387-1395.
Ajmera V, et al. A prospective study on the prevalence of NAFLD, advanced fibrosis, cirrhosis and hepatocellular carcinoma in people with type 2 diabetes. J Hepatol. 2022. doi: 10.1016/j.jhep.2022.11.010. [Epub ahead of print]
Anstee QM, et al. Noninvasive tests accurately identify advanced fibrosis due to NASH: baseline data from the STELLAR trials. Hepatology. 2019;70:1521-1530.
Shah AG, et al. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 2009;7:1104-1112.
Srivastava A, et al. Prospective evaluation of a primary care referral pathway for patients with non-alcoholic fatty liver disease. J Hepatol. 2019;71:371-378.
Mansour D, et al. Embedding assessment of liver fibrosis into routine diabetic review in primary care. JHEP Rep. 2021;3:100293.
Younossi ZM et al. Algorithms using noninvasive tests can accurately identify patients with advanced fibrosis due to NASH: data from the STELLAR clinical trials. Presented at: American Association for the Study of Liver Diseases; November 9-13, 2018; San Francisco, California. Abstract LB-10. https://www.natap.org/2018/AASLD/AASLD_181.htm
Davies MJ, et al. Management of hyperglycemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45:2753-2786.
Azoulay L, et al. The use of pioglitazone and the risk of bladder cancer in people with type 2 diabetes: nested case-control study. BMJ. 2012;344:e3645.
Tamaki N, et al. Risk of advanced fibrosis in first-degree relatives of patients with nonalcoholic fatty liver disease. J Clin Invest. 2022;132:e162513.
Caussy C, et al. Nonalcoholic fatty liver disease with cirrhosis increases familial risk for advanced fibrosis. J Clin Invest. 2017;127:2697-2704.
Pavlides M, et al. Interobserver variability in histologic evaluation of liver fibrosis using categorical and quantitative scores. Am J Clin Pathol. 2017;147:364-369.
Dufour JF, et al. Current therapies and new developments in NASH. Gut. 2022;71:2123-2134.
Patton H, et al. AGA clinical practice update on bariatric surgery in cirrhosis: expert review. Clin Gastroenterol Hepatol. 2020;19:436-445.
Loomba R, et al. Expert panel review to compare FDA and EMA guidance on drug development and endpoints in nonalcoholic steatohepatitis. Gastroenterology. 2021;162:680-688.

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CME Information

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Faculty and Disclosures

Faculty

Rohit Loomba, MD, MHSc

Editors

Anne G. Le, PharmD

Gina Montanero, PharmD, RPh

Compliance Reviewer

Yaisanet Oyola, MD

Peer Reviewer

CME

How Would You Assess These Patients for Liver Fibrosis?

Credits Available

You Are Eligible For

Target Audience and Goal Statement

Disclosures

Faculty

Rohit Loomba, MD, MHSc

Editors

Anne G. Le, PharmD

Gina Montanero, PharmD, RPh

Compliance Reviewer

Yaisanet Oyola, MD

Peer Reviewer

Accreditation Statements

For Physicians

Instructions for Participation and Credit

How Would You Assess These Patients for Liver Fibrosis?

References