Researchers modeled 20-year outcomes for patients with nonalcoholic steatohepatitis (NASH) in the US and found a generally higher clinical and economic burden associated with patients with obesity and NASH compared to those with nonobese NASH.

This research was presented as an abstract the American Association for the Study of Liver Diseases by Zobair Younossi, MD, from Inova Fairfax Medical Campus in Falls Church, Virginia.

The researchers simulated 20-year outcomes for hypothetical cohorts of NASH patients in the US, stratified by age and presence of obesity. The main outcomes tracked were cardiac- and liver-specific deaths, liver transplants, years of decompensated cirrhosis, years of hepatocellular carcinoma, and costs. The costs studied included inpatient, outpatient, professional services, emergency department, and drug costs.

This model predicted that over 2 decades (2019-2040) the cohort of obese patients with NASH would have higher all-cause mortality (74.1%) than nonobese patients (59.1%); higher cardiac-specific mortality (26.4% vs 7.4%); and liver-specific mortality (2.7% vs 2.3%). Obese patients with NASH were also estimated to require 48,855 liver transplants compared to 8,332 among nonobese patients, and substantially more total patient-years of years of decompensated cirrhosis (1.139 million vs 193,998) and hepatocellular carcinoma (743,833 vs 103,795) than their nonobese NASH patient counterparts. In addition, the expected costs for the obese NASH cohort were estimated to be $161.91B, while the nonobese NASH cohort had costs estimated to be $30.94B.

Considering their findings, the researchers state that as obesity continues to rise, “related NASH will have a major clinical and economic impact on the U.S.” Moving forward, the researchers, wrote, policy makers and other stakeholders should take obesity and its prevalence into consideration when addressing the growing burden of NASH in the United States.

—Allison Casey

Reference:

Younossi Z, et al. Burden of Illness and Economic Impact of Nonalcoholic Steatohepatitis (NASH) in the United States According to the Presence of Obesity. Presented at: the American Association for the Study of Liver Disease annual meeting. November 12-15. Virtual.