Change in MRI-PDFF and Histologic Response in Patients With Nonalcoholic Steatohepatitis: A Systematic Review and Meta-Analysis.
Change in MRI-PDFF and Histologic Response in Patients With Nonalcoholic Steatohepatitis: A Systematic Review and Meta-Analysis.
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DOI：
10.1016/j.cgh.2020.08.061
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Loomba R
中科院分区：
文献类型：
--
作者：
Stine JG;Munaganuru N;Barnard A;Wang JL;Kaulback K;Argo CK;Singh S;Fowler KJ;Sirlin CB;Loomba R
Magnetic resonance imaging proton density fat fraction (MRI-PDFF) offers promise as a non-invasive biomarker of treatment response in early-phase nonalcoholic steatohepatitis (NASH) trials. We performed a systematic review to quantify the association between a ≥ 30% reduction in MRI-PDFF and histologic response in NASH. We searched the Cochrane Library, Embase, Medline and trial registries through May 2020 for early-phase clinical trials that incorporated MRI-PDFF and examined histologic response following intervention in adults with NASH. Subjects were classified as MRI-PDFF responders (relative decline in liver fat ≥30%) or non-responders (relative decline in liver fat <30%). MRI-PDFF responders versus non-responders were compared. Primary outcome was histologic response defined as a 2-point improvement in NAFLD Activity Score with at least 1-point improvement in lobular inflammation or ballooning. Secondary outcome was NASH resolution. Proportions and random effects odds ratios (OR) with corresponding 95% confidence intervals (CI) were calculated. Seven studies met inclusion criteria, comprising 346 subjects (median age 51 years; 59% female; 46% with diabetes). MRI-PDFF responders were significantly more likely to have a histologic response (51% vs 14%, p <0.001; OR 6.98, 95% CI 2.38–20.43, p<0.001) and NASH resolution (41% vs 7%, p<0.001; OR 5.45, 95% CI 1.53–19.46, p=0.009) compared to non-responders. This meta-analysis demonstrates that a ≥30% relative decline in MRI-PDFF is associated with higher odds of histologic response and NASH resolution. These results support the use of MRI-PDFF in non-invasive monitoring of treatment response in early-phase NASH clinical trials and provide helpful data for sample-size estimation for histology-based assessment.
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DOI：
10.1002/hep.26455
发表时间：
2013-12
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Noureddin M;Lam J;Peterson MR;Middleton M;Hamilton G;Le TA;Bettencourt R;Changchien C;Brenner DA;Sirlin C;Loomba R
通讯作者：
Loomba R
影响因子：
13.5
作者：
Harrison, Stephen A.;Rossi, Stephen J.;DePaoli, Alex M.
通讯作者：
DePaoli, Alex M.
影响因子：
5.1
作者：
Filozof C;Chow SC;Dimick-Santos L;Chen YF;Williams RN;Goldstein BJ;Sanyal A
通讯作者：
Sanyal A
影响因子：
39.2
作者：
Hutton, Brian;Salanti, Georgia;Moher, David
通讯作者：
Moher, David
影响因子：
4.2
作者：
Patel, Janki;Bettencourt, Ricki;Loomba, Rohit
通讯作者：
Loomba, Rohit