The results provide new evidence to improve the diagnosis of these conditions and reduce the need for liver biopsies. The research is part of the international LITMUS program, which aims to develop and evaluate biomarkers for these liver diseases.
The main study, published in The Lancet, analyzed 26 biomarkers in 1,590 patients. It compared blood tests, biomarker panels, and elastography techniques against biopsy results. The SOMAScan proteomic panel and techniques like magnetic resonance elastography (MRE) and FibroScan showed high accuracy in detecting advanced liver fibrosis and cirrhosis. ELF and ADAPT blood tests also met performance thresholds for identifying cirrhosis.
Detecting MASH cases with progression risk proved more challenging, with only the SOMAScan panel achieving the pre-established diagnostic accuracy threshold. Gamma-glutamyl transferase (gamma-GT), a simple blood test, outperformed the widely used FIB-4 score as a first-line tool.
Researchers propose a stepped diagnostic strategy starting with gamma-GT, followed by tests like ELF or FibroScan, and advanced imaging techniques for specialized care. This approach could optimize healthcare resource use and reduce invasive procedures.
The second study, published in Nature Medicine, evaluated 24 diagnostic tests in 357 patients. Magnetic resonance elastography demonstrated superior accuracy to FibroScan in detecting advanced fibrosis and cirrhosis.
MASLD affects approximately 25% to 30% of the global population. Its severe form, MASH, can progress to cirrhosis and liver cancer. The development of specific treatments makes accurate diagnostic tests crucial for identifying eligible patients and monitoring their progress.
