First NASH drug to report a successful phase 3 trial
It is very early and we don't know a lot yet but Intercept Pharmaceuticals has just released results of their Phase 3 test of Obeticholic Acid as a possible treatment for NASH.
This is a major step for us as patients. We all know the story. The doc says sadly, "You have cirrhosis, I'm sorry we have no treatment". This is a refrain we see retold thousands of times here at the Foundation and it is the path I have personally traveled. I've written that we are on the brink of a new day when we will have options. This is the dawning of that day.
This information is primarily for physicians but may be of value to some of our patients. As a patient, it is important to know that the interpretation of a Fibroscan score is not simple. The meaning of a test depends upon what caused the liver damage as we can see in this scoring guide.
In light of this, it is important that a qualified physician makes the interpretation of your test results. Some of the guidance available for physicians is found in these documents.
Fibroscan Physician Interpretation Training
Fibroscan Clinical Publications
What is going wrong with my liver? How do I get tested? What is Fibroscan?
- Did you know that liver disease is often without symptoms?
- Did you know that it is very common to learn you have stage 4 fibrosis or cirrhosis as your first warning?
- Did you know that cirrhosis is not curable?
- Did you know that doctors will tell you not to worry about fatty liver even though it can lead to cirrhosis?
OK can you tell me what really happens?
The key is to understand what you do to yourself. Here are a few videos that will help you understand the problem.
This first video is generally good but simplifies the explanation of a complex problem in order to make it short. However, the general overview is instructive but makes it sound too simple. Dr Reddy markets his services through videos. We are not involved with his clinic but his video is helpful. More specific details of liver disease are included in following videos for those who want to understand specifics.
In the liver the danger of the fatty liver disease process is basically the fat accumulating in your liver when it shouldn't, mostly because of your bad diet. That sets you up for liver damage which harms almost every organ in your body. These videos explain what happens in the liver when you eat poorly and explains screening for disease.
These videos take you into the bio-chemistry. If you are going to manage your liver problems you have to believe the message that lifestyle and diet are fundamental. If you understand the fundamentals you are equipped to make wise choices about your day to day lifestyle.
Something to be aware of is that fatty liver disease, caused by a constant liver stress resulting from a bad diet, sets you up for a variety of diseases. To understand this it is important to realize that the liver is central to energy use and storage which are fundamental to you being alive. This energy process uses lipoproteins which are managed by the liver as you can learn in this brief video.
One of the first systems to begin to fail with liver damage is insulin management which leads to diabetes. You may find it interesting that medicine treats diabetes but treatments for the root cause, compromised liver function, are limited.
Boy that sucks. How can I get my liver tested?
Sadly liver fibrosis production is mostly silent and there is no warning before it becomes serious. Doctors watch for elevated liver enzymes in blood tests and may do an occasional ultrasound. The unfortunate truth is that enzymes aren't usually elevated until significant damage is done and an ultrasound doesn't give any warning until the liver is at least 30% fat. If you are overweight you can assume that you are accumulating fat in your liver but screening tests are limited. Once fibrosis begins to form a specialized ultrasound called Fibroscan can detect those changes in the liver.
Here is a clinical lecture which goes into detail on liver disease diagnosis and the use of Fibroscan. It is excellent but is an hour long.