Catch up on the 9 FDA drug approvals most relevant to primary care, including new options for HIV-1 infection, narcolepsy, diabetes, pain management, and more.
News|Articles|July 14, 2023
Daily Dose: T2D Raises Risk for Hepatic Decompensation, Hepatocellular Carcinoma in Patients with NAFLD
Author(s)Sydney Jennings
Advertisement
Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.
On July 11, 2023, we reported on a study published in the Lancet Gastroenterology and Hepatology that examined the risk of hepatic decompensation in patients with nonalcoholic fatty liver disease (NAFLD) and without type 2 diabetes (T2D).
The study
The meta-analysis comprised individual participant level data from 6 international cohorts whose participants had magnetic resonance elastography (MRE) between February 27, 2007, and June 4, 2021. In addition to liver fibrosis identified by MRE, eligible studies included longitudinal assessment for hepatic decompensation and death and participants were adults aged ≥18 years with NAFLD who had data supporting a diagnosis of T2D at baseline.
The initial cohort numbered 2016; 53.5% were women, mean age was 57.8 years, and mean body mass index was 31.3 kg/m2. After excluding participants who had hepatic decompensation at baseline and those without longitudinal data, there were 1737 participants in the group for final analysis, of whom 602 had T2D at baseline.
The findings
Over a median follow-up of 2.8 years, 105 participants (11.8%) developed hepatic decompensation or died without hepatic decompensation. The risk of hepatic decompensation (sHR, 95% CI) was significantly higher among participants with T2D vs no T2D at 1, 3, and 5 years.
The analysis for HCC included 1802 participants 639 with (T2D). Over a median follow-up of 2.9 years, 22 participants (18 with baseline T2D, 4 without), developed incident HCC. Similar to the risk of hepatic decompensation, risk of incident HCC at 1, 3, and 5 years was significantly greater among participants with T2D vs without T2D.
A note from authors
"The higher risk of hepatic decompensation and HCC in people with type 2 diabetes should be considered when designing clinical trials in NAFLD. These data serve as a call to action to prevent type 2 diabetes and reduce the growing burden of NAFLD and NAFLD-related hepatocellular carcinoma.”
Click here for more details.
Advertisement
Related to this article
Evolocumab was associated with a 20% lower risk of fatal or nonfatal myocardial infarction than ezetimibe among more than 544 000 adults with ASCVD.
The FDA cleared Access MeMed BV, a host-response blood test that helps distinguish bacterial from viral infections in adults and children in as little as 15 minutes.
Greater Mediterranean diet adherence was associated with lower odds of adult acne, particularly among women, in a UK Biobank study of dietary patterns.
Abbott's investigational device achieved 96.3% complete left atrial appendage closure by echocardiography, with a 1.8% ischemic stroke rate at 1 year.
October FDA news included updates on long-acting olanzapine, multi-cancer blood testing, stroke rehabilitation, and heart failure monitoring.
Christoph Correll, MD, discusses the new once-monthly olanzapine injection for schizophrenia, including clinical efficacy, metabolic risks, and patient selection.
Cheryl Cox Kinney, MD, explains when night sweats warrant further evaluation, including red flags, persistent symptoms, and potential nonmenopausal causes.
Advertisement
Advertisement