2018: A Liver Year In Review
Port Washington News
The year 2018 was an exciting year in liver diseases. It saw much progress to diagnosing, treating and providing improved access to care.
There were no new treatments introduced for hepatitis C this previously killer disease is simple to cure in almost all infected patients. Instead, focus has been shifted towards public policies aimed at eliminating hepatitis C and on improving access to its curative, life-saving therapies.
Non-alcoholic Fatty Liver Disease
Initially thought to be a benign disease, the importance of assessing disease severity is being disseminated to health care providers and patients. While liver biopsy had been the sole modality available to assess for degree of steatosis and fibrosis, readily available blood tests and advanced imaging techniques such as transient elastography and special MRIs are making it easier to rapidly assess and stage this condition. While diet, exercise and weight loss remain the current treatment, 2018 saw several new innovative, oral therapies being used reporting positive results in clinical trials. These results should lead to the first medications being approved by the FDA in early 2020.
Primary Liver Cancer
Once thought to have a horrible prognosis, survival from primary liver cancer is improving. 2018 saw new chemotherapeutic agents being approved for its treatment which are better tolerated and have improved efficacy. These new agents, in combination with refined radiological therapies and liver transplantation, have made this condition manageable and curable in many patients who previously were not treatment candidates.
Primary sclerosing cholangitis
For the first time, this deadly condition with no adequate approved therapies is seeing several new agents being evaluated for treatment. While it is still early in development, just the fact that there are potential therapies being considered is exciting, groundbreaking and hopefully will bring much needed relief to the many people affected with this condition.
Alcoholic Liver Disease
Here the news is not good. Alcoholic liver disease is on the rise in
While 2018 saw progress, there are still certain specific liver diseases where much work needs to be done. Hepatitis B can be suppressed but cure remains elusive and access to suppressive therapies is complicated by high cost. Autoimmune hepatitis has not seen much progress or even clinical studies with new agents making long term steroid and immunosuppressive agents the treatments of choice, despite their potential longterm side effects. For now, I would like to wish everyone a happy and a healthy New Year.