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Advanced fibrosis associated with non-alcoholic steatohepatitis (NASH) in Spain: results of a Delphi study

Abstract: Objective: To describe in detail the epidemiology, diagnosis, clinical management, treatment options, impact on quality of life and unmet needs of patients with advanced liver fibrosis (F3?F4) associated with non-alcoholic steatohepatitis (NASH) in Spain. Methodology: Delphi study of two rounds of consultation rounds with 41 expert hepatologists from 16 autonomous communities to collect their experience in clinical practice. Results: The estimated prevalence of adult patients diagnosed with F3?F4 fibrosis associated with NASH in Spain is 0.019% (95% confidence interval [CI]: 0.019?0.020%). Approximately 7588 adults with this condition are currently diagnosed and managed in the Digestive System Services of Spanish hospitals, and around 1881 new patients are diagnosed each year. Management is multidisciplinary and includes the specialties of Digestive System, Endocrinology and Internal Medicine, considering the frequently associated metabolic comorbidities (obesity, type 2 dia-betes mellitus or dysmetabolic iron overload). Despite a clear impact on quality of life, this it is not routinely evaluated in clinical practice. The most widely used non-invasive diagnostic tech-niques are transitional elastography and liver fibrosis index 4 (FIB-4). The absence of effective and safe treatments appears as the main unmet need for the management of these patients. Conclusions: This study provides a representation of the current situation of patients diagno-sed with F3-F4 fibrosis associated with NASH in Spain, increasing the evidence available and contributing to informed decision-making by professionals and the health system.

 Fuente: Gastroenterología y Hepatología, 2024, 47, 337-346

 Editorial: Elsevier

 Año de publicación: 2024

 Nº de páginas: 10

 Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.gastre.2023.06.003

 ISSN: 0210-5705

 Url de la publicación: https://doi.org/10.1016/j.gastre.2023.06.003

Autoría

ALLER, ROCÍO

CALLEJA, JOSÉ LUIS

ROMERO-GÓMEZ, MANUEL

TURNES, JUAN

BENMARZOUK-HIDALGO, OMAR J.

SUBIRÁN, RAFAEL

GIL, ALICIA