Shows
Surfing the MASH TsunamiS6.12.3 - After the Semaglutide Approval: What Next For MASH Therapy?Send us a textKey Opinion Leaders Manal Abdelmalek, Naim Alkhouri, Scott Isaacs and Zobair Younossi join Roger Green to discuss the FDA's approval of semaglutide for patients with non-cirrhotic MASH. This conversation centers on the roles that new technologies and an expanded APP population will play in MASLD and MASH management in the US, and concludes by exploring how care might look different 12 months from now, and then in subsequent years. As panelists identify some of the changes they foresee if we are to manage the tsunami of undiagnosed MASLD patients, many comments touch o...
2025-09-0221 minSurfing the MASH TsunamiS6.12.2 - After the Semaglutide Approval: Expanding MASH Awareness Will Change Medical PracticesSend us a textKey Opinion Leaders Manal Abdelmalek, Naim Alkhouri, Scott Isaacs and Zobair Younossi join Roger Green to discuss the FDA's approval of semaglutide for patients with non-cirrhotic MASH. This conversation focuses on how the US healthcare system must adapt to handle the growing number of MASH and MASLD patients who might seek treatment, given likely increases in publicity and education.The conversation starts with a focus on the implications of semaglutide approval for hepatologists. Naim states that many hepatologists are currently uncomfortable managing patients on GLP-1 agonists. This will need to change...
2025-08-3122 minSurfing the MASH TsunamiS6.12.1 - After the Semaglutide Approval: Impact on Patients and PharmacotherapySend us a textKey Opinion Leaders Manal Abdelmalek, Naim Alkhouri, Scott Isaacs and Zobair Younossi join Roger Green to discuss FDA's approval of semaglutide for patients with non-cirrhotic MASH. This conversation focuses on benefits for patients and ways that having two drugs with different modes of action will change pharmacotherapy choices.This conversation starts with the group describing the sense of "enthusiasm" and "fulfillment" hepatology drug developers feel to see two drugs approved in the US and many other major changes to come (more drug approvals, FDA acceptance of a path to approval that i...
2025-08-3124 minSurfing the MASH TsunamiS6.12 - A Second US Drug Approval! What Semaglutide's Success Portends For MASLD Care in the USSend us a text00:00:00 - Surf's Up, Season 6, Episode 12This week's episode is a special three-part roundtable on the implications of the FDA's recent approval of semaglutide. Naim Alkhouri, Manal Abdelmalek, Scott Isaacs and Zobair Younossi join Roger Green in a discussion that focuses less on specifics of pharmacotherapy and more on how having two drugs available will change MASH management in the US.00:08:45 - Part I: How Will The Semaglutide Approval Affect Patient Treatment and Pharmacotherapy?The group starts by describing the sense of "enthusiasm" and "fulfillment" hepatology drug developers feel to...
2025-08-291h 04Surfing the MASH Tsunami6.9.3 - Expert: Naim Alkhouri Discusses His Long Friendship with Stephen Harrison and His New Role at Summit Clinical ResearchSend us a textHepatologist and hepatology key opinion leader Naim Alkhouri joins Roger Green to remember his longstanding relationship with Stephen Harrison, announce his new role as Chief Academic Officer at Summit Clinical Research and share how, in this role, he will have exciting new avenues make an impact on many elements of MASH drug development and patient care. The conversation can be divided into two sections. In the first, Naim recounts his relationship with Stephen Harrison, beginning with his move to a different San Antonio clinical trial practice and continuing through his tenure a...
2025-08-0629 minSurfing the MASH Tsunami6.9 - Complexities of Behavior Change, Devices That Can Help, Future of Clinical Trials and MedEdSend us a text00:00:00 - Surf's Up: Episode 6.9This conversation covers three topics. The first discusses the challenges of behavior change in dietary habits and ways governments can help, the second looks at what one can learn from wearing a CGM for 30 days, and the third celebrates the late Stephen Harrison while looking into the future of clinical trials and medical education. 00:06:12 - Global Think-Tank on SLD Roundtable, Part 3Behavior consultant Dr. Kristina Curtis joins Jörn Schattenberg, Louise Campbell and Roger Green to discuss issues related to patient-centered care. This conversation starts by...
2025-08-021h 17
CLDF PodcastResmetirom: The First FDA-Approved Therapy for MASHThank you Madrigal for your support on this podcast episode. Join Dr. Steven Flamm, Rush University Medical School, and Dr. Naim Alkhouri, Arizona Liver Health, for an in-depth discussion on Resmetirom — the first FDA-approved treatment for adults with MASH (Metabolic Dysfunction-Associated Steatohepatitis) and moderate to advanced fibrosis. In this expert-led podcast, the panel explores the groundbreaking clinical data behind Resmetirom, including findings from the MAESTRO-NASH trial, which demonstrated fibrosis regression and NASH resolution after just one year of treatment. Drs. Flamm and Alkhouri review real-world patient experiences, optimal use of non-invasive tests (like FibroScan, ELF, and MRI-PDFF), pr...
2025-05-2823 minSurfing the MASH TsunamiS6 - E6 - Remembering Stephen Harrison and His Many Contributions to MASH00:00:00 Surf's Up, Season 6, Episode 6.On April 23, 2024, our colleague and co-founder, Stephen Harrison, passed away suddenly. This week, Surfing the MASH Tsunami remembers Stephen with two of his closest associates and continues our annual MASH Drug Development roundtable held in his honor. 00:00:04:24 - A Deep Dive into Drug Development, Part 2The second portion of the Drug Development roundtable primarily focuses on three key issues. The first, uptake of resmetirom, starts with Naim Alkhouri discussing his experience in the Arizona Liver Health Clinics with over 650 patients in the year since resmetirom was approved and shifts t...
2025-04-2657 minSurfing the MASH TsunamiS6 - E5.1 - FGF-21s and A Promising Future on CirrhosisThis conversation is the opening segment of SurfingMASH's April discussion, in memory of Stephen A. Harrison, on drug development. In addition to co-hosts Jörn Schattenberg, Louise Campbell and Roger Green, panelists include hepatologists and key opinion leaders Sven Francque and Naim Alkhouri. This opening discussion focuses on exciting advances in one drug class (FGF-21s) and, more broadly, on exploring ways to treat cirrhosis. As Naim points out in his opening comment, these two issues— cirrhosis as a challenge and FGF-21s as a possible solution path —intersect in clear and exciting ways. He notes that the FG...
2025-04-2224 minSurfing the MASH TsunamiS6 - E5 - Drug Development Week: FGF-21s, Cirrhosis, Resmiterom, Gene Therapies00:00:00 - Surf's Up: Season 6 Episode 5Host Roger Green briefly describes this episode’s three sections and introduces Roundtable guests. The Roundtable panel shares groundbreakers. 00:10:39 - Roundtable: A Deep Dive Into Drug Development, Part OneThe opening portion of this month's roundtable centers around two issues: exciting data for FGF-21s and, more generally, treating patients with cirrhosis. Naim Alkhouri sets the tone in his opening comments, which start by focusing on the exciting SYMMETRY data from efruxifermin and then hones in on FGF-21s and resmetirom in cirrhosis. The rest of the conversation fea...
2025-04-181h 09Surfing the MASH TsunamiS6 - E1: Two Multispecialty February Conferences and Europe Prepares for Resmetirom00:00:00 - Surf's Up! Season 6 Episode 1SurfingMASH kicks off our sixth season in our new format, with three major elements to each episode. This week's Roundtable and Newsmakers segments focused on two recent conferences that took a multispecialty perspective on the range of medical and psychological issues affecting steatotic liver disease (a new concept specialty: steatology.") Our Expert this week is our co-host Jörn Schattenberg, discussing the educational and conceptual challenges of readying Europe for the EMA approval of resmetirom later this year.00:03:58 - Introductions and GroundbreakersHost Roger Green describes the new v...
2025-03-211h 13Surfing the MASH TsunamiS5 - E26.5 - Looking Back at #TLM2024 - Promoting Healthy Livers and Looking Ahead to 2025In this episode, Naim Alkhouri, Mike Betel, Michelle Long and Jeff McIntyre join Jörn Schattenberg and Roger Green to look back at The Liver Meeting 2024. This conversation reviews two sessions promoting healthy livers and asks panelists what they anticipate for #TLM2025. This last conversation starts with Jeff describing the session that moved him most and praising a panel that Mike co-chaired on Lifestyle Management of MASLD and MASH. Jeff spoke on this panel, and he describes the breadth and quality of speakers and topics. While Jeff spoke about social determinants of health, others discussed commercial, regulatory a...
2025-01-0315 minSurfing the MASH TsunamiS5 - E26.4 - Looking Back at #TLM2024 - Patient Advocacy and Patient-Centric TrialsIn this episode, Naim Alkhouri, Mike Betel, Michelle Long and Jeff McIntyre join Jörn Schattenberg and Roger Green to look back at The Liver Meeting 2024. This conversation considers the role of patient advocacy in replacing biopsy in clinical trials with NITs and reviews a session on the foundational principles for patien-centric clinical trials. This conversation picks up at the end of Michelle's discussion of the FDA Corner session. Jeff starts by identifying this specific issue - replacing biopsy in clinical trials with NITs - as a place topic on which he believes patients must play a p...
2025-01-0311 minSurfing the MASH TsunamiS5 - E26.2 - Looking Back at #TLM2024 - Patient Genotyping and MASH ClustersIn this episode, Naim Alkhouri, Mike Betel, Michelle Long and Jeff McIntyre join Jörn Schattenberg and Roger Green to look back at The Liver Meeting 2024. This conversation considers how the anticipated approval of a second MASH drug without biopsy might affect clinical trials and discusses two recent publications on patient genotyping and patient clusters. The conversation starts with Roger asking the group whether the presence of two approved MASH medications that do not require biopsy will make recruiting clinical trials that require them more challenging. The group doubts this will not add a significant new challenge t...
2025-01-0214 minSurfing the MASH TsunamiS5 - E26.3 - Looking Back at #TLM2024 - FGF-21 Agents and the FDA CornerIn this episode, Naim Alkhouri, Mike Betel, Michelle Long and Jeff McIntyre join Jörn Schattenberg and Roger Green to look back at The Liver Meeting 2024. This conversation reviews the late-breaker presentation on efimosermin, a q4w FGF-21 agent and the "FDA Corner" session. Jörn begins the discussion by highlighting a paper from the later breaker session on efimosfermin alfa, an FGF-21 agent dosed q4w. He notes that after only six doses (24 weeks), efimosfermin alfa demonstrated significant increases in fibrosis regression and lowering NAS score. To Jörn, this result, coupled with others on efruxifermin and...
2025-01-0213 minSurfing the MASH TsunamiS5 - E26.1 - Looking Back at #TLM2024 - Semaglutide Passes the ESSENCE TestIn this episode, Naim Alkhouri, Mike Betel, Michelle Long and Jeff McIntyre join Jörn Schattenberg and Roger Green to look back at The Liver Meeting 2024. This conversation reviews the ESSENCE trial, the Phase 3 trial demonstrating that semaglutide regresses fibrosis levels in some MASH patients. The conversation begins with each panelist sharing a word or short phrase they felt best captured their feelings about TLM2024. Next, panelists review the meeting's most consequential paper, the ESSENCE Trial. Naim starts by describing ESSENCE, a Phase 3 trial with semaglutide demonstrating significant levels of fibrosis regression in non-cirrhotic MASH patients. Jörn...
2025-01-0213 minSurfing the MASH TsunamiS5-26 - One Month Later: Looking Back at MASLD/MASH Coverage From The Liver Meeting 202400:00:00 – Surf’s Up: Season 5 Episode 26 - Last month, close to 8,000 hepatology stakeholders convened in San Diego for The Liver Meeting 2024. Hepatology Key Opinion Leader Naim Alkhouri, Novo Nordisk International Vice President for Medicines Michelle Long, and patient advocates Jeff McIntyre from the Global Liver Institute and Michael Betel from the Fatty Liver Alliance join Jörn Schattenberg and Roger Green to discuss highlights. 00:03:23 - Introduction and Groundbreaker - Highlights include recent travel, cultural events, and the Third Annual Primary Care Summit from the Fatty Liver Alliance.00:11:35 - Describing TLM2024 - Participants shared a word or short...
2024-12-201h 11Surfing the MASH TsunamiS5 - E20.5 - Drug Development Highlights From EASL Congress 2024: Denifenstat, SPECIAL and Other StoriesMazen Noureddin and Naim Alkhouri join Jörn Schattenberg and Roger Green to discuss some of the other major drug development stories from the EASL Congress 2024, with special focus on denifenstat, ION-224 and TAK-227, and to review the SPECIAL study on bariatric surgery and cirrhosis. The panelists concur that all three of these agents have potential value in therapy. Naim expresses some concern about how broad denifestat use will be based on its side effect profile. Later in this conversation, Mazen belives that denifenstat has broad potential for use, given that the most prominent side effect, hair th...
2024-06-2313 minSurfing the MASH TsunamiS5 - E20.4 - Drug Development Highlights From EASL Congress 2024: Are FGF-21s Induction Therapy or a "MASH Cure"?Mazen Noureddin and Naim Alkhouri join Jörn Schattenberg and Roger Green to focus on the role FGF-21s will play in long-term advanced fibrosis treatment: induction or long-term therapy...or might we even think of the class as being able to produce a "MASH cure?" Responding to Naim's comment closing the previous discussion, Mazen questions why we regard FGF-21 agents as induction therapies given that it appears to be as well tolerated as the oral agents and maintains such efficacy over time. In fact, he adds, its sustained efficacy might make it possible for livers to el...
2024-06-2310 minSurfing the MASH TsunamiS5 - E20.3 - Drug Development Highlights From EASL Congress 2024: "Twin-cretins" and efruxiferminNaim Alkhouri and Mazen Noureddin join Jörn Schattenberg and Roger Green to discuss issues regarding incretin agonists and results from the efruxiermin late-breaker at the EASL Congress 2024. Naim shares his general excitement about glucagon agents in general. He mentions that the efinopegdutide study included a semaglutide cell, which showed further reduction in liver fat vs. the GLP-1 agent. Jörn comments on the high level of tolerability in the survodutide trials. Mazen shares his high hopes for GLP/glucagons and the triple agents. He goes back to review the survodutide data from the NEJM ar...
2024-06-2214 minSurfing the MASH TsunamiS5 - E20.2 - Drug Development Highlights From EASL Congress 2024: Tirzepatidate and other "Twin-cretins"Mazen Noureddin and Naim Alkhouri join Jörn Schattenberg and Roger Green to discuss the tirzepatide late-breaker at the EASL Congress 2024 and other "Twin-cretins," all of which are GLP-glucagon combinations. "Twin-cretins" is the name Jörn has coined for agents with a GLP-1 agonist plus another incretin effect. Tirzepatide is a GLP/GIP agent, while survodutide and the agents discussed last year, pemvidutide and efinopegdutide, are GLP/gluagons. Naim reviews the results of the tirzepatide late-breaker presentation. As expected, it showed high rates of MASH resolution. Naim does not feel it answered the question whether an i...
2024-06-2211 minSurfing the MASH TsunamiS5 - E20.1 - Drug Development Highlights From EASL Congress 2024: ResmetiromNaim Alkhouri and Mazen Noureddin join Jörn Schattenberg and Roger Green to discuss some of the new research on resmetirom at the EASL Congress 2024.Mazen begins this discussion by covering a paper he presented on Stephen's behalf, looking at dose-response with resmetirom. The analysis indicated that PDFF and histology improvements at the 100mg dose were greater than at the 80mg dose. Mazen speculates that the higher dose might provide a greater anti-fibrotic response as well, although, in a world where biopsy is not required for prescribing, he doubts the study will ever be done. Jörn not...
2024-06-2210 minSurfing the MASH TsunamiS5 - E20 - Lessons From EASL Congress 2024: Exciting Advances in Drug Development00:00:00 Surf's Up, Season 5 Episode 20Naim Alkhouri and Mazen Noureddin join co-hosts Jörn Schattenberg and Roger Green to discuss major drug development stories from the EASL Congress 2024. They pay tribute to Stephen Harrison and proceed to groundbreakers.00:08:16 - Presentations on ResmetiromMazen shares a paper he presented looking at resmetirom dose-response. The 100mg dose performed better than the 80mg dose. Jörn notes that the most important element of the study might be the demonstrated 36-month effect. 00:14:19- Implications of Different Analytical Modes Naim compares different modes of analysis. Intent to Treat, whi...
2024-06-2057 min
EASL PodcastsEASL Studio Podcast: Resmetirom: First approved drug for MASH, for whom and for how long?This episode explores the approval of resmetirom for NASH, analysing its integration into clinical practice and patient eligibility. The experts also discuss the role of lifestyle interventions alongside resmetirom, the use of biomarkers for patient selection, treatment monitoring, and the expected landscape changes over the next five years.FacultyAleksander Krag (Moderator)Naim Alkhouri (Faculty)Sven Francque (Faculty)Amalia Gastaldelli (Faculty)Related episodesSeason 5 , Episode 2: Are 30% of the global population sick? A critical view on Steatotic Liver Disease and care pathwaysEASL Studio from EASL Congress 2023: Steatotic liver disease global consensus...
2024-05-1635 minSurfing the MASH TsunamiS5 E14.2 - Remembering Stephen Harrison: Professional AccomplishmentsManal Abdelmalek and Naim Alkhouri join co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to reflect on the greatest professional accomplishments of co-founder and former co-host Dr. Stephen Harrison.Naim Alkhouri starts this conversation by describing the two prospective epidemiology papers Stephen co-authored at San Antonio Military Medical Center in 2011 and 2021, an innovative design that provided early estimates of the breadth of MASLD and MASH in an asymptomatic population. He goes on to discuss Stephen's work on FAST and other NITs and finishes by remembering Stephen's exceptional work in drug development, culminating in the recent FDA a...
2024-05-1208 minSurfing the MASH TsunamiS5 E14.1 - Remembering Stephen Harrison: Personal MemoriesManal Abdelmalek and Naim Alkhouri join co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to share personal memories of co-founder and former co-host Dr. Stephen Harrison. Naim Alkhouri starts the conversation by describing how he met his "friend and mentor," Stephen. He recalls coming to San Antonio in 2017 to work with a different research group and contacting Stephen. Stephen told Naim he had "made the wrong decision" by not joining his team instead. Nonetheless, Naim persisted, and the two began a rich, rewarding friendship and research experience, which Naim describes in greater detail.Jörn...
2024-05-1215 minSurfing the MASH TsunamiS5 - E14.3 - Remembering Stephen Harrison: "Harrisonisms"Manal Abdelmalek and Naim Alkhouri join co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to rshare some of their favorite "Harrisonisms" - words, phrases and verbal memes associated with co-founder and former co-host Dr. Stephen Harrison.Naim Alkhouri starts by stating two of his favorite Harrisonisms, two that SurfingMASH listeners know well: "is the juice worth the squeeze?" and "Keep It Simple, Stupid." He goes on to add one that never appeared on the podcast, "FAIL stands for First Attempt In Learning," which he u...
2024-05-1110 minSurfing the MASH TsunamiS5 - E14 - Remembering Stephen Harrison - colleagues share memories and impressions of an SLD masterThe sudden passing on April 23 of our co-founder and colleague Stephen Harrison sent shock waves throughout the global SLD community. This week, Manal Abdelmalek and Naim Alkhouri join Jörn Schattenberg, Louise Campbell and Roger Green to remember and pay tribute to an exceptional leader, role model and human being.00:00:00 - Surf's Up: Season 5 Episode 14Episode introduction, including brief quotes taken directly from panelists. 00:03:11 - IntroductionRoger introduces the podcast. The three key opinion leaders, Jörn Schattenberg, Manal Abdelmalek and Naim Alkhouri, discuss their fast-paced, high intensity travel schedules.00:04:41 - Gr...
2024-05-0837 minSurfing the MASH TsunamiS5 - E13.2 - Global Fatty Liver Day 2024 And The Rationale Behind "Act Now. Get Screened."This conversation centers around the Global Fatty Liver Day 2024 theme and the rationale behind focusing on screening.It starts with Jeff describing how much has changed in MASLD in the past year and why this calls for a new focus. Jeff identifies the breadth of the global challenge of treating MASLD and related conditions, which is far broader than "just having one medicine for one aspect of the disease in one country." To Jeff and GLI, the best immediate path forward is to bring more patients into the system through screening, which provides the rationale for GLI's...
2024-05-0412 minSurfing the MASH TsunamiS5 - E13 - Previewing Global Fatty Liver Day 2024Fatty Liver Alliance Founder and President Mike Betel and Global Liver Institute Vice President for Liver Programs Jeff McIntyre join Louise Campbell and Roger Green to preview the premier MASH event for patient advocates, now known as Global Fatty Liver Day, which falls on June 13.00:00:00 - Surf's Up: Season 5 Episode 13 Episode introduction, including brief quotes taken directly from panelists. 00:02:37 - Introduction/Remembering Stephen HarrisonRoger introduces the podcast. Each panelist shares a memory of Stephen Harrison.00:11:44 - Groundbreaker Each panelist shares one piece of good news from the previous week.
2024-05-021h 02Surfing the MASH TsunamiS5 - E9.4 - In-office MASLD Screening and the Clinical Care PathwayThis conversation explores the implications of increased access to economically viable in-office screening, particularly when primary care practices begin to use the new scanning devices.Roger Green begins this conversation by recalling a concern Naim Alkhouri expressed during S4 E50.3, that primary care reliance on FIB-4 can flood the pathways with many “wrong” patients, which might lead to confusion within the channels. Hannes Hagstrom describes a role for primary care at the top of the funnel if practitioners have clear guidance and training. Roger suggests this approach will make primary care providers triagists. The group agrees as long...
2024-04-0711 minSurfing the MASH TsunamiS5 - E5.5 - More on GLP-1s and a Broader MASH Wrap-upAfter some final discussion about GLP-1s, this conversation entails Roger Green summarizing what he has heard in the episode so far and testing for confirmation or correction. It goes fast and covers significant ground. Naim Alkhouri starts this conversation by discussing patients for whom he would prescribe resmetirom vs. GLP-1s. Lean MASH patients are likely to receive resmetirom. Earlier fibrosis patients are more likely to receive semaglutide. A multimorbid F3 patient might receive both. Roger asks how things might change with tirzepatide, since it is a dual agonist with strong MASH-lowering effects. Naim ex...
2024-03-1011 minSurfing the MASH TsunamiS5 - E5.4 - The dance of drug pricing and patient targets in MASH, PLUS: the role of GLP-1sThis conversation touches on two important subjects: the impact of different potential resmetirom prices on the size and structure of the treatable MASH population, and the impact GLP-1s are having (and will have) on clinical trial recruitment and basic patient treatment. It starts with Naim Alkhouri expressing concern over the $39-52K price he has heard for resmetirom, which ICER has deemed cost-effective. He mentions another paper that says a price of $19,000 would be cost-effective. To Naim, this magnifies a question that is already quite widely considered: when to prescribe resmetirom vs. a GLP-1 agent. He d...
2024-03-1011 minSurfing the MASH TsunamiS5 - E5.3 - Strategies to Improve NIT reliability in Diagnosing and Staging MASH FibrosisThis conversation focuses more tightly on the specific challenges with the current approaches that use NITs to diagnose and stage advanced MASH fibrosis and explores several newer options and ways of thinking about the challenge.Roger Green notes that recent papers discuss the failure to predict accurately with FIB-4. He asks how we can improve predictive performance. Louise Campbell notes some specific challenges, after which Jörn Schattenberg praises John Dillon's work in automating lab detection algorithms. He also reiterates his view that repeat testing will be pivotal in good test protocols. Ian Rowe rejoins the conversation (f...
2024-03-1014 minSurfing the MASH TsunamiS5 - E5.2 - NITs In The Diagnosis and Treatment Of Advanced MASH Fibrosis PatientsThis conversation explores the challenges with using the current non-invasive tests (NITs) to diagnose patients with F2/F3 advanced MASH fibrosis. If tests today cannot achieve the requisite level of precision, panelists explore other ways to define patient targets. Roger Green starts by recalling that in a recent episode (Season 5 Episode 2), Jeff McIntyre suggested that in the US, the initial patient population may be as small as a few hundred thousand people. Ian Rowe states that current tools are incapable of placing these patients in a narrow diagnostic or therapeutic window. Jörn Schattenberg takes a "pragmatic" a...
2024-03-1012 minSurfing the MASH TsunamiS5 - E5.1 - Why We Are Focusing On NITs For MASH Diagnosis And ScreeningThis conversation explores why proper use of non-invasive tests (NITs) will play a pivotal role in increasing the number of patients diagnosed and treated for MASH. It becomes particularly pivotal if, as expected, the first MASH drug is approved later this month. Roger Green starts this conversation by describing why he considers NIT use and adoption one of the two pivotal patient treatment issues for 2024. Jörn Schattenberg notes that he has not received any referrals from PCPs or endocrinology based on elevated FIB-4, which would happen if enough front-line treaters were adopting the new clinical care p...
2024-03-1008 minSurfing the MASH TsunamiS5 - E5 - How Non-Invasive Tests (NITs) For MASLD And MASH Might Evolve In 2024In 2024, the two major areas for change in diagnosing and treating MASH are new drug approval and changes in use of NITs. Naim Alkhouri and Ian Rowe join Jörn Schattenberg, Louise Campbell and Roger Green to consider what might change with NITs and how having an approved drug might change thinking on this issue.00:00:00 - Surf's Up: Season 5 Episode 5Opening introduction, including brief quotes taken directly from the episode discussion.00:02:36 - Introduction and GroundbreakerPanelists congratulate Naim on the recent, highly successful Desert Liver Conference. In the groundbreaker, each panelist shares one pi...
2024-03-0757 minSurfing the MASH TsunamiS4 E50.5 - Wrapping Up 2023 - An Interview with Hannes HagstromSurfing the MASH Tsunami continues its 2023 wrap-up conversations with hepatology researcher, key opinion leader and 2023 UEG Rising Star of the Year Hannes Hagstrom, along with co-hosts Louise Campbell and Roger Green. The conversation focuses largely on issues in diagnostics and clinical care pathways.The conversation starts with Hannes describing highlights of 2023 as positive drug trials, excellent in-person meetings and the new nomenclature. Asked to clarify, he focuses on how the new nomenclature focuses on the interaction of alcohol consumption and what was previously called "non-alcoholic" disease. As a second point, he discussed the ability to use non-invasive tests...
2023-12-2727 minSurfing the MASH TsunamiS4 E50.3 - Wrapping Up 2023 - An Interview With Naim AlkhouriSurfing the MASH Tsunami continues its 2023 wrap-up conversations with hepatology researcher and key opinion leader Naim Alkhouri of the Arizona Liver Health Institute, along with co-hosts Louise Campbell and Roger Green. The conversation focuses on viewing the year's major events in drug development, non-invasive tests (NITs) and clinical care pathways.This conversation starts with Roger asking Naim his reaction to 2023. Naim starts by mentioning his disappointment that OCA did not get approved but shares his vision that the data presentation did not support approval and his hope and belief that resmetirom will fare better. From there, he...
2023-12-2329 minSurfing the MASH TsunamiS4-E49.6 - Conversations From The Vault -- NITs At TLM2022This Vault conversation stems from the wrap-up to TLM2022. In the episode, the panel (Jörn Schattenberg, William Alazawi, Naim Alkhouri, Laurent Castera, Ken Cusi, Wayne Eskridge and Roger Green) addresses several topics from the program. This one focuses largely on NITs. This conversation focuses on several papers of interest to Laurent. The first is a prospective screening study on patients with diabetes seen in either primary care or a diabetes clinic in the US. Using NITs to screen for NASH and MRE to screen for advanced disease, they identified 65% with NAFLD, 14% with advanced fibrosis and 5% with ci...
2023-12-0316 minSurfing the MASH TsunamiS4-E47 - Previewing The Liver Meeting 2023: Abstracts of InterestLast week's posting consisted of 1:1 interviews with four KOL from different spheres, each talking with Roger Green about what they are looking forward to seeing at this week's The Liver Meeting 2023. This week, two of those KOLs, co-host Jörn Schattenberg and hepatology KOL Naim Alkhouri, join Roger and co-host Louise Campbell, FRCP, in a free-wheeling review of key abstracts that will be presented at TLM2023.The discussion begins with Jörn spotlighting the first item in the abstract book, a presentation titled MASH Resolution Without Fibrosis Worsening After Bariatric Surgery Improves Long-Term Survival. Jörn spotlights this stu...
2023-11-0942 minSurfing the MASH TsunamiS4-E46.3 - The Liver Meeting 2023: Updates with Key Opinion Leader, Naim AlkhouriThis week on Surfing NASH, host Roger Green embarks on a series of one on one interviews with KOLs and patient advocates to talk about the Liver Meeting 2023 (held in Boston from November 10 - 14) and much more. In this conversation, friend of the podcast, Naim Alkhouri, joins to discuss this highly anticipated event as well as offer a glimpse into his current work and research interests.The Liver Meeting is known for its exceptional educational content and amazing presenters. This year will be no exception and, if you can't make it to Boston, the state-of-the-art lectures will...
2023-11-0520 minSurfing the MASH TsunamiS4-E41.5 - Veronica Miller on “why are we validating a surrogate with a surrogate?”In Season 4, Episode 41, the surfers (Jörn Schattenberg, Louise Campbell and Roger Green) review highlights from the FDA's NIT workshop in three seperate interview sessions with guests Naim Alkhouri, Laurent Castera and Veronica Miller. Each guest participated in some form at the meeting and shares slightly differing but incredibly insightful perspectives.This conversation is the first part of the Surfer’s interview with Veronica. Veronica starts by commending FDA for organizing the workshop and indicates that now we all need to process the data. Roger asks Veronica what FDA might have done better, and she indicates they mig...
2023-09-2415 minSurfing the MASH TsunamiS4-E41.4 - NITs to Qualify Patients for Trials vs to Evaluate Efficacy of DrugsIn Season 4, Episode 41, the surfers (Jörn Schattenberg, Louise Campbell and Roger Green) review highlights from the FDA's NIT workshop in three seperate interview sessions with guests Naim Alkhouri, Laurent Castera and Veronica Miller. Each guest participated in some form at the meeting and shares slightly differing but incredibly insightful perspectives.This conversation begins with discussing a point from a previous episode in 2022 about the difference between NITs to qualify patients for trials versus to evaluate efficacy of drugs. This point stems from the idea that the way disease regresses may not be the same wa...
2023-09-2411 minSurfing the MASH TsunamiS4-E41.3 - Laurent Castera on the FDA's NIT WorkshopIn Season 4, Episode 41, the surfers (Jörn Schattenberg, Louise Campbell and Roger Green) review highlights from the FDA's NIT workshop in three seperate interview sessions with guests Naim Alkhouri, Laurent Castera and Veronica Miller. Each guest participated in some form at the meeting and shares slightly differing but incredibly insightful perspectives.This conversation introduces the first part of an interview with Laurent Castera. Roger starts by asking Laurent how he, as one of the few non-American presenters, felt about the meeting. Laurent noted how important the meeting was given that it came from FDA, which th...
2023-09-2314 minSurfing the MASH TsunamiS4-E41.2 - Naim Alkhouri on clinical trial populations and the future decisions of FDAIn Season 4, Episode 41, the surfers (Jörn Schattenberg, Louise Campbell and Roger Green) review highlights from the FDA's NIT workshop in three seperate interview sessions with guests Naim Alkhouri, Laurent Castera and Veronica Miller. Each guest participated in some form at the meeting and shares slightly differing but incredibly insightful perspectives.Roger starts this conversation by discussing loss aversion – the idea that an individual’s decision does not reflect an overall fear of risk, but a specific fear of risking something they do not want to lose. Researchers and advocates define loss in terms of time t...
2023-09-2315 minSurfing the MASH TsunamiS4-E41.1 - Naim Alkhouri on an NIT-based alternative path to conditional approvalIn Season 4, Episode 41, the surfers (Jörn Schattenberg, Louise Campbell and Roger Green) review highlights from the FDA's NIT workshop in three seperate interview sessions with guests Naim Alkhouri, Laurent Castera and Veronica Miller. Each guest participated in some form at the meeting and shares slightly differing but incredibly insightful perspectives. This conversation covers the first part of our interview with Naim, who served as an expert panelist in Tuesday’s penultimate session. The conversation starts with Naim commending the session and noting that what drug developers and principal investigators truly are seeking is an NIT-b...
2023-09-2313 minSurfing the MASH TsunamiS4-E41 - Reviewing the FDA's NIT WorkshopOn September 18-19, the FDA hosted a workshop to update key stakeholders on the state-of-the-art use of biomarkers and noninvasive tests (NITs) based on recent advances in NASH/metabolic dysfunction associated steatohepatitis (MASH) clinical trials. In this episode, Surfing NASH reviews highlights from the workshop in three seperate interview sessions with guests Naim Alkhouri, Laurent Castera and Veronica Miller. Each guest participated in some form at the meeting and shares slightly differing but incredibly insightful perspectives with Surfers Jörn Schattenberg, Louise Campbell and Roger Green. Naim elaborates on the limitations of current pathways and the possibilities of...
2023-09-221h 18Surfing the MASH TsunamiS4-E36.5 - LOCATE-NAFLD: What’s Next and Practical TakeawaysCo-hosts Louise Campbell and Roger Green are joined by friend of the podcast, Naim Alkhouri, and new guest, Professor James O’Beirne, to discuss learning from liver disease in Australia and developing improved models for patient identification and risk stratification.This final conversation starts with Roger discussing the idea that upscaling training is very important. Louise follows up with a comment that we must remember these are complicated technologies to use and that dedication to training is pivotal in optimizing their potential. After a digression to consider the size of the indigenous candidates in the study, the gr...
2023-08-1310 minSurfing the MASH TsunamiS4-E36.4 - LOCATE-NAFLD: Funding and Generating DataCo-hosts Louise Campbell and Roger Green are joined by friend of the podcast, Naim Alkhouri, and new guest, Professor James O’Beirne, to discuss learning from liver disease in Australia and developing improved models for patient identification and risk stratification.This conversation focuses largely on funding, starting with Louise’s question about Medicare payment for patients in Australia. James notes that all care was free to patients, and that this might skew results. As the conversation continues, Louise notes the importance for Australians of having Australian data to use in valuing medicines, diagnostics and procedures, given that NICE...
2023-08-1315 minSurfing the MASH TsunamiS4-E36.3 - LOCATE-NAFLD: Cost Effectiveness and Implementation in Different SystemsCo-hosts Louise Campbell and Roger Green are joined by friend of the podcast, Naim Alkhouri, and new guest, Professor James O’Beirne, to discuss learning from liver disease in Australia and developing improved models for patient identification and risk stratification.This conversation starts with Louise discussing some of the improvements in patient motivation and compliance as a result of FibroScan when administered in specialty sites. From here Roger asks Louise and James how they envision practical implementation of this kind of study design in other countries. Louise speculates on how this might work in 3rd world countries wh...
2023-08-1211 minSurfing the MASH TsunamiS4-E36.2 - LOCATE-NAFLD: Study Design and Early AnalysisCo-hosts Louise Campbell and Roger Green are joined by friend of the podcast, Naim Alkhouri, and new guest, Professor James O’Beirne, to discuss learning from liver disease in Australia and developing improved models for patient identification and risk stratification.This conversation proceeds from a high-level overview of the LOCATE-NAFLD study. Discussion opens to comments from the panelists, starting with Naim commending the basic idea of a randomized study and the sample size for this initiative. He goes on to ruminate on how effective this design will be at correctly assessing positive and negative predictive values. James de...
2023-08-1211 minSurfing the MASH TsunamiS4-E36.1 - Meeting James O’Beirne and Introducing the LOCATE-NAFLD StudyCo-hosts Louise Campbell and Roger Green are joined by friend of the podcast, Naim Alkhouri, and new guest, Professor James O’Beirne, to discuss learning from liver disease in Australia and developing improved models for patient identification and risk stratification.This conversation starts with an introduction to James both personally and professionally. A Consultant Hepatologist at the Sunshine Coast University Hospital, James describes how he came to his work and interests around risk stratification in liver disease, particularly in NAFLD, hepatocellular carcinoma and portal hypertension. From here Louise shares a bit about why she feels the LOCATE-NAFLD st...
2023-08-1213 minSurfing the MASH TsunamiS4-E36 - LOCATE-NAFLD: Improved Models for Patient Identification and Risk StratificationCo-hosts Louise Campbell and Roger Green are joined by friend of the podcast, Naim Alkhouri, and new guest, Professor James O’Beirne, to discuss liver disease in Australia and developing improved models for patient identification and risk stratification.James , a Consultant Hepatologist at the Sunshine Coast University Hospital, shares his professional background and introduces events which lead to the LOCATE-NAFLD study. After Australia became the first country to allow access to direct-acting antiviral agents for HCV in 2016, there was the strong need to determine which patients were cirrhotic. With relatively unprepared primary care providers, specialist and hospital ca...
2023-08-1056 minSurfing the MASH TsunamiS4-E27.1 - Unpacking the Program with Ian Rowe and Jörn SchattenbergSurfing NASH extends its preview coverage of the upcoming EASL Congress with a three-part episode. First up, Ian Rowe and Jörn Schattenberg speak to Roger Green about anticipations around the 2023 program and which abstracts are eye-catching and why. This conversation comes from that session and begins with Ian’s selection of a highly-anticipated abstract which will detail data from the MAESTRO-NASH clinical trial of resmetirom for the treatment of NASH and liver fibrosis. Specifically, Ian looks to learn more about the potential prevention of progression of fibrosis. Jörn adds the note that this abstract will be the firs...
2023-06-1713 minSurfing the MASH TsunamiS4-E26.3 - FibroScan and the Impact of Socioeconomic Factors on Liver HealthThursday, June 8 was International #NASHDay 2023 and the podcast hosted a special session featuring patient advocates Gina Villiotti Madison (NASH kNOWledge), Marko Korenjak (European Liver Patients' Association) and Michael Betel (Fatty Liver Alliance). With co-hosts Louise Campbell and Roger Green, the group shares both a positive and sobering discussion around the Fatty Liver public health epidemic and its impact on younger generations now and into the imminent future.Roger starts this conversation by asking the panel about other groups and organizations each is working to reach in an effort to increase education and awareness. The first observations revolve ar...
2023-06-1016 minSurfing the MASH TsunamiS4-E23.2 - The Future of AI-Assisted Digital Pathology and NITsStephen Harrison joins Louise Campbell and Roger Green for an insight-laden episode about challenges and opportunities in NASH drug development. This conversation breaks away from commentary around the FDA ADCOM meeting on obeticholic acid after Louise begins with a synopsis of the meeting outcome and her general agreement with the preceding conversation’s analysis. From there Roger shifts focus to a powerhouse paper produced by Stephen (and co-authored by friends of the podcast Alina Allen, Julie Dubourg, Mazen Noureddin and Naim Alkhouri) which was published in Nature Medicine earlier in March 2023. When asked what would be the one or tw...
2023-05-2714 minSurfing the MASH TsunamiS4-E10.5 - From the Vault: 2022 Liver Conference: Pediatric NAFLD and Liver Health EducationThis episode From the Vault comes from the 2022 Liver Conference, where over 400 liver disease stakeholders gathered in Scottsdale, Arizona for the event sponsored by the Chronic Liver Disease Foundation (CLDF). The main meeting ran on a Friday and Saturday and was preceded on Thursday by a half-day session devoted exclusively to NASH (NASH Connect). Episode 15.3 of Season 3 and its conversations capture some of the thinking that went into the program design and some highlights of the NASH-related sessions.This conversation focuses on the issue of pediatric NASH and NAFLD. Naim Alkhouri discusses the urgent need to include...
2023-03-0512 minSurfing the MASH TsunamiS4-E10.4 - Pediatric and Adolescent Fatty Liver: Impact of Emerging Drugs and TrialsIn yet another topical debut, Surfing NASH explores pediatric and adolescent Fatty Liver disease, its alarming incidence rate and developing the field's understanding around how to treat a vulnerable subpopulation. The Surfers are joined in discussion by Naim Alkhouri and chief of Gastroenterology, Hepatology and Nutrition at Children’s Hospital Los Angeles, Rohit Kohli, for a special session which illuminates a public health crisis intimate to the two extremely knowledgeable guests.Roger Green leads this final conversation with an apt metaphor. He suggests that a population facing increasing severity downstream is like dealing with a momentous snowball ro...
2023-03-0507 minSurfing the MASH TsunamiS4-E10.3 - Pediatric and Adolescent Fatty Liver: Implementing Real World InterventionsIn yet another topical debut, Surfing NASH explores pediatric and adolescent Fatty Liver disease, its alarming incidence rate and developing the field's understanding around how to treat a vulnerable subpopulation. The Surfers are joined in discussion by Naim Alkhouri and chief of Gastroenterology, Hepatology and Nutrition at Children’s Hospital Los Angeles, Rohit Kohli, for a special session which illuminates a public health crisis intimate to the two extremely knowledgeable guests.This conversation begins with Louise Campbell’s note that, on average, it takes 17 years for clinical trials to be implemented in real world settings. She asks whet...
2023-03-0412 minSurfing the MASH TsunamiS4-E10.2 - Pediatric and Adolescent Fatty Liver: Cardiometabolic Complications and Challenges in NITsIn yet another topical debut, Surfing NASH explores pediatric and adolescent Fatty Liver disease, its alarming prevalence and developing the field's understanding around how to treat this vulnerable subpopulation. The Surfers are joined in discussion by Naim Alkhouri and chief of Gastroenterology, Hepatology and Nutrition at Children’s Hospital Los Angeles, Rohit Kohli for a special session which illuminates a critical issue intimate to the two extremely knowledgeable guests.Jörn Schattenberg steers this conversation toward the cardiometabolic complications behind patients living longer with Fatty Livers. Naim describes a paper which sought to strengthen understanding of epidemiology by...
2023-03-0415 minSurfing the MASH TsunamiS4-E10.1 - Increasing Incidence of Pediatric and Adolescent Fatty LiverIn yet another topical debut, Surfing NASH explores pediatric and adolescent Fatty Liver disease, its alarming prevalence and developing the field's understanding around how to treat this vulnerable subpopulation. The Surfers are joined in discussion by Naim Alkhouri and chief of Gastroenterology, Hepatology and Nutrition at Children’s Hospital Los Angeles, Rohit Kohli for a special session which illuminates a critical issue intimate to the two extremely knowledgeable guests.Roger Green prefaces this conversation with the observation that as a pandemic of Fatty Liver disease grows at boggling speed, so too does NAFLD and NASH in younger po...
2023-03-0409 minSurfing the MASH TsunamiS4-E10 - Focus on Pediatric and Adolescent Fatty Liver DiseaseIn yet another topical debut, Surfing NASH explores pediatric and adolescent Fatty Liver disease, its alarming prevalence and developing the field's understanding around how to treat this vulnerable subpopulation. The Surfers are joined in discussion by Naim Alkhouri and chief of Gastroenterology, Hepatology and Nutrition at Children’s Hospital Los Angeles, Rohit Kohli. This is a special session which illuminates a critical issue intimate to two extremely knowledgeable guests. Rich with invaluable insights, the panelists elaborate on the following major themes:08:55Roger Green prefaces this conversation with the observation that as...
2023-03-0247 minSurfing the MASH TsunamiS4-E9.3 - Diabetes Drug Choices With Benefits For NAFLDThis week, SurfingNASH is offering conversation segments to showcase our new series, The NASH Tsunami in Diabetes: Getting Ahead of the Rising Tide. Rising Tide, as we call it, is a subscription-only series targeted at the primary care physicians, endocrinologists and allied health professionals who provide front-line treatments for patients living with Type 2 Diabetes and/or obesity. This preview looks at drug choices prescribers can make today for patients with Type 2 Diabetes Mellitus and obesity that have positive impact on Fatty Liver disease. In addition to co-hosts Dr. Ken Cusi and Roger Green, panelists for this discussion include endocrinologist...
2023-02-2519 minSurfing the MASH TsunamiS4-E8.5 - The Future of Digital TherapeuticsFor the first time, Surfing NASH takes a deep dive into the prospect of digital therapeutics, their ability to drive outcomes and the critical success factors for proper use and deployment. This is an increasingly apt topic which intermittently surfaces on the podcast but has never featured at the center of conversation. The Surfers are joined by Naim Alkhouri and two new guests with prominent focus in this space: Joe Rubinsztain, CEO and Co-Founder of ChronWell, and Mark Berman, CMO of Better Therapeutics.In this final session, Roger prompts the panelists to share final thoughts around how...
2023-02-1910 minSurfing the MASH TsunamiS4-E8.4 - Digital Apps: Patient Participation and Regulatory ChallengesFor the first time, Surfing NASH takes a deep dive into the prospect of digital therapeutics, their ability to drive outcomes and the critical success factors for proper use and deployment. This is an increasingly apt topic which intermittently surfaces on the podcast but has never featured at the center of conversation. The Surfers are joined by Naim Alkhouri and two new guests with prominent focus in this space: Joe Rubinsztain, CEO and Co-Founder of ChronWell, and Mark Berman, CMO of Better Therapeutics.In this session, the group continues to discuss the benefits behind having an app...
2023-02-1911 minSurfing the MASH TsunamiS4-E8.3 - Joe Rubinsztain on ChronWell and Scalable TechnologyFor the first time, Surfing NASH takes a deep dive into the prospect of digital therapeutics, their ability to drive outcomes and the critical success factors for proper use and deployment. This is an increasingly apt topic which intermittently surfaces on the podcast but has never featured at the center of conversation. The Surfers are joined by Naim Alkhouri and two new guests with prominent focus in this space: Joe Rubinsztain, CEO and Co-Founder of ChronWell, and Mark Berman, CMO of Better Therapeutics.In this conversation, Joe details the inception of ChronWell and the company’s mission of...
2023-02-1814 minSurfing the MASH TsunamiS4-E8.2 - Feasibility Study: Cognitive Behavior Therapy for Improved Liver HealthFor the first time, Surfing NASH takes a deep dive into the prospect of digital therapeutics, their ability to drive outcomes and the critical success factors for proper use and deployment. This is an increasingly apt topic which intermittently surfaces on the podcast but has never featured at the center of conversation. The Surfers are joined by Naim Alkhouri and two new guests with prominent focus in this space: Joe Rubinsztain, CEO and Co-Founder of ChronWell, and Mark Berman, CMO of Better Therapeutics. Naim leads this conversation by elaborating on his involvement in a feasibility study with B...
2023-02-1813 minSurfing the MASH TsunamiS4-E8.1 - Utilizing Prescription Digital Therapeutics to Combat Fatty LiverFor the first time, Surfing NASH takes a deep dive into the prospect of digital therapeutics, their ability to drive outcomes and the critical success factors for proper use and deployment. This is an increasingly apt topic which intermittently surfaces on the podcast but has never featured at the center of conversation. The Surfers are joined by Naim Alkhouri and two new guests with prominent focus in this space: Joe Rubinsztain, CEO and Co-Founder of ChronWell, and Mark Berman, CMO of Better Therapeutics.In this conversation, Joe and Mark detail their backgrounds and respective roles at two...
2023-02-1813 minSurfing the MASH TsunamiS4-E8 - Focus on Digital Health with Better Therapeutics and ChronWellFor the first time, Surfing NASH takes a deep dive into the prospect of digital therapeutics, their ability to drive outcomes and the critical success factors for proper use and deployment. This is an increasingly apt topic which intermittently surfaces on the podcast but has never featured at the center of conversation. The Surfers are joined by Naim Alkhouri and two new guests with prominent focus in this space: Joe Rubinsztain, CEO and Co-Founder of ChronWell, and Mark Berman, CMO of Better Therapeutics.Among a plethora of discussion points unpacked, the panelists explore the following...
2023-02-1658 minSurfing the MASH TsunamiS4-E4.4 - NASH-TAG 2023: Emerging Optimism from a Watershed MomentAs the podcast hosts insights from our very own audience this week, we are extending three additional conversations from recent reviews of a particularly exciting NASH-TAG 2023. This session features highlights from the wrap-up episode chat with Amy Articolo and Naim Alkhouri joining Jörn Schattenberg and Roger Green.The leading question asks the panelists to rate their levels of enthusiasm emerging from the conference in Deer Valley. The scale ranges from 1 to 6, where 1 represents “thoroughly depressed” and 6 represents “over the moon.” A similar question at the conclusion of NASH-TAG 2022 elicited 4s and 5s… This time the answers ranged from...
2023-01-2212 minSurfing the MASH TsunamiS4-E3.4 - NASH-TAG Review: Insights on the F3 Population and AI-Assistance for Improving Therapeutic EfficacyNASH-TAG 2023 proved to be a watershed moment for Fatty Liver disease as exciting drug development readouts, powerful academic work on non-invasive tests and the willingness to dive into the toughest questions aligned in Deer Valley, Utah. In this weekend’s conversation series, Surfing NASH reviews its diverse coverage of the conference by showcasing key excerpts across six recordings with various KOLs, patient advocates and stakeholders.This conversation with Naim Alkhouri, Amy Articolo and Jörn Schattenberg begins with Naim illustrating some of the high points of the meeting. First, he recaps the resmetirom data. He then highlights tha...
2023-01-1518 minSurfing the MASH TsunamiS4-E3 - NASH-TAG Wrap-Up: Therapeutic Efficacy of Resmetirom, NITs and Regulatory ScienceFor our look back at NASH-TAG 2023, Jörn Schattenberg and Roger Green are joined by Amy Articolo and Naim Alkhouri for a discussion which dives into the therapeutic efficacy of recently announced data on resmetirom, NITs, bariatric surgery and more. Adjoining this session is a bonus interview with Donna Cryer on her impressions and key takeaways which largely look into the movement of regulatory science. In combination, this two-part episode encompasses contrasting and thought-provoking perspectives on addressing the opportunities and challenges in moving the Fatty Liver field forward.Naim opens the first conversation by noting the positivity e...
2023-01-121h 15Surfing the MASH TsunamiS3-E63.1 - Year-End Interview with Naim AlkhouriIn the Season 3 NAFLD Year-in-Review conversations series, Surfers Jörn Schattenberg, Louise Campbell and Roger Green embark on a string of interviews with a handful of Key Opinion Leaders who made headlines and advances in Fatty Liver disease in 2022. In this exclusive segment, Naim Alkhouri joins Louise and Roger to discuss drugs, NITs, digital diagnostics and the importance of preventing pediatric and adolescent NAFLD.Naim begins by highlighting the FDA approval of the ELF test, which has assisted him in the risk stratification of patients who fall in the indeterminant zone. He then underscores an impressive spate o...
2022-12-3040 minSurfing the MASH TsunamiS3-E63 - 2022 NAFLD Year-in-Review Interview Series, Part 3The latter half of December marks the Surfing the NASH Tsunami annual NAFLD Year-in-Review. In Part 3 of this Season 3 finale, Surfers Jörn Schattenberg, Louise Campbell and Roger Green interview Naim Alkhouri, Stephen Harrison and Ian Rowe to discuss putting a dent in Fatty Liver disease in 2022 and beyond. This final episode of the year features compiled excerpts from our respective guest interviews. Each interview in its entirety will debut as independent segments released over the weekend.Surf on to hear the diverse and powerful perspectives provided by a handful of the field’s Key Opinion Leaders who...
2022-12-291h 05Surfing the MASH TsunamiS3-E56.6 - From the Vault: Focus On NASH Cirrhosis: Trials in Process and a Plea For MREThis episode From the Vault follows Season 2, Episode 43 in discussing the possible role of NASH cirrhosis clinical trials in the transition from biopsy as gold standard to a post-biopsy world. Terns Pharma CEO Sen Sundaram joins this conversation from the audience to ask whether the term “cirrhosis” is medically helpful or might warrant replacement with “end stage liver disease.” After vigorous discussion on this point, Sen departs and Stephen Harrison leads the group through a review of four ongoing NASH cirrhosis trials. The discussion veers into the issue of which analytics methods designers are specifying and why. At one point, N...
2022-11-2721 minSurfing the MASH TsunamiS3-E55.5 - Pediatric and Lean NASH: Learning from Diverse PopulationsGiven the vast amount of information and insight from The Liver Meeting, this episode sought to identify and explore a few key highlights. The panel (Jörn Schattenberg, William Alazawi, Naim Alkhouri, Laurent Castera, Ken Cusi, Wayne Eskridge and Roger Green) addresses several topics from the program.This final conversation examines the diversity of populations with NASH and other ways we can learn from and about them. Naim begins by discussing work with pediatric NASH, specifically noting the shortcomings of NITs for these patients. Ken and Roger note the diverse forms of NASH, including both lean and p...
2022-11-2012 minSurfing the MASH TsunamiS3-E55.4 - Emerging Roles for ELF Test and Advances in Use of PPARsGiven the vast amount of information and insight from The Liver Meeting, this episode sought to identify and explore a few key highlights. The panel (Jörn Schattenberg, William Alazawi, Naim Alkhouri, Laurent Castera, Ken Cusi, Wayne Eskridge and Roger Green) addresses several topics from the program.Naim begins this conversation with mentioning Labcorp’s announcement that a reflex ELF test is available for patients with high FIB-4. The latter will be computed if the patient has a complete blood count (CBC) and a comprehensive metabolic panel (CMP). As Naim notes, this is similar to the Hep C p...
2022-11-2011 minSurfing the MASH TsunamiS3-E55.3 - NIT Efficacy in Primary Care and Diabetes Clinic SettingsGiven the vast amount of information and insight from The Liver Meeting, this episode sought to identify and explore a few key highlights. The panel (Jörn Schattenberg, William Alazawi, Naim Alkhouri, Laurent Castera, Ken Cusi, Wayne Eskridge and Roger Green) addresses several topics from the program.This conversation focuses on several papers of interest to Laurent. The first is a prospective screening study on patients with diabetes seen in either primary care or a diabetes clinic in the US. Using NITs to screen for NASH and MRE to screen for advanced disease, they identified 65% with NAFLD, 14% w...
2022-11-1915 minSurfing the MASH TsunamiS3-E55.2 - Comparing Global Health Systems, Standardizing AST and Educating on NAFLD PrevalenceGiven the vast amount of information and insight from The Liver Meeting, this episode sought to identify and explore a few key highlights. The panel (Jörn Schattenberg, William Alazawi, Naim Alkhouri, Laurent Castera, Ken Cusi, Wayne Eskridge and Roger Green) addresses several topics from the program.Ken leads this conversation with an analogy from the diabetes field. He describes the impact of albumin screening in urine on helping primary care treaters focus on diabetes screening and, ultimately, providing better information to patients. He shares his hope that a simple test, like FIB-4, will illuminate direction in t...
2022-11-1916 minSurfing the MASH TsunamiS3-E55.1 - Insights from Fatty Liver Foundation’s Annual Survey of Patient PerspectivesGiven the vast amount of information and insight from The Liver Meeting, this episode sought to identify and explore a few key highlights. The panel (Jörn Schattenberg, William Alazawi, Naim Alkhouri, Laurent Castera, Ken Cusi, Wayne Eskridge and Roger Green) addresses several topics from the program. This conversation focuses on an ongoing initiative of the Fatty Liver Foundation called the Annual Survey of Patient Perspectives.Wayne introduces this 713-patient survey which sought to understand and monitor the evolving social and medical experiences of NAFLD patients in the US. The results of the study were presented at T...
2022-11-1911 minSurfing the MASH TsunamiS3-E55 - 2022 AASLD Wrap-Up: Reviewing a Momentous MeetingGiven the vast amount of information and insight from The Liver Meeting, this episode sought to identify and explore a few key highlights. Even so, there is more in this episode than a brief summary can capture. The panel (Jörn Schattenberg, William Alazawi, Naim Alkhouri, Laurent Castera, Ken Cusi, Wayne Eskridge and Roger Green) addresses several topics from the program:Wayne presents information from a survey Fatty Liver Foundation conducted with NAFLD patients. The study reported that very few patients received adequate information at time of diagnosis, and one in three do not even receive a specialist r...
2022-11-171h 01Surfing the MASH TsunamiS3-E45.5 - From the Vault: What Can NAIL-NIT Retrospective Analysis Tell Us About NASH?In Season 3, Episode 19, the content focus looks at what the retrospective analysis from the NAIL-NIT consortium can achieve in terms of moving the shift beyond the biopsy in NASH diagnostics forward.This conversation starts with Stephen discussing how challenging it was to develop initial FDA test criteria for evaluating NASH drugs. Many years later, he notes, we have learned how flawed these criteria were, several in ways we cannot fix, but we need to do better. He relates this to what the British author Rupert Sheldrake describes as “morphic resonance” or mysterious telepathy type interconnections between organisms and...
2022-09-2012 minSurfing the MASH TsunamiS3-E43 - Combination Agents: a Cornerstone Of Future NASH Therapy?This episode explores the future of combination agents in NASH Therapy. First author Naim Alkhouri and last author Mazen Noureddin join the Surfers to discuss their recently published article, Safety and efficacy of combination therapy with semaglutide, cilofexor and firsocostat in patients with non-alcoholic steatohepatitis: A randomised, open-label phase II trial (JHEP, 2022). While the conversation starts by focusing on this article, the discussion itself takes a far broader look at the strategies behind developing combination agents, the likely role these combination therapies will play in treating patients, and, more generally, what Mazen Noureddin describes as the coming “combo-combo” world.
2022-09-011h 03
GI InsightsNavigating Non-Alcoholic Fatty Liver Disease: Diagnostic & Management Strategies
Host: Peter Buch, MD, FACG, AGAF, FACP
Guest: Naim Alkhouri, MD
Non-alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease in the United States and affects about one-quarter of the population. So what are the risk factors for developing NAFLD, and how can we monitor its progression and manage our patients? Joining Dr. Peter Buch to answer these and other key questions is Dr. Naim Alkhouri, Chief of Transplant Hepatology and the Director of the Fatty Liver Program at Arizona Liver Health.
2022-06-2900 minSurfing the MASH TsunamiS3-E21.3 - Digital Health and Behavioral Support apps in Future NASH TherapiesThis conversation includes part of a more extended discussion that Naim Alkhouri had with Louise Campbell and Roger Green when he stopped by the virtual SurfingNASH.com studios to discuss his recent work.This conversation winds up focusing on digital health and future therapies, but it starts down a funny path on the way there. Louise Campbell returns to the question of CAP scores to note that when she sees someone with a CAP of 2.48 or slightly higher, she can use that score to motivate patients to change their regimens. This comment leads to agreement between Louise...
2022-04-2313 minSurfing the MASH TsunamiS3-E21.2 - NAFLD Incidence in All Americans and The NASH-Diabetes LinkThis conversation includes part of a longer discussion that Naim Alkhouri had with Louise Campbell and Roger Green when he stopped by the virtual SurfingNASH.com studios to discuss his recent work.Naim dives right into the conversation by mentioning that he has had two papers published within the last week or two. One is from the EDICT Trial, a multi-year evaluation of Type 2 Diabetes patients where half are randomly assigned a course of "conventional" step therapy, and the others are assigned an immediate course of a more up-to-date combination therapy. The conventional therapy includes metformin, followed...
2022-04-2312 minSurfing the MASH TsunamiS3-E21 - Naim Alkhouri and Donna Cryer Bring News to Surfing the NASH TsunamiArizona Liver Health Institute V.P. of Academic Affairs and Fatty Liver Program Director Naim Alkhouri and Global Liver Institute Founder and CEO Donna Cryer join Louise Campbell and Roger Green to discuss their recent projects and accomplishments. Each of them brings newsworthy stories that lead to thoughtful, stimulating conversations about a range of issues.Naim Alkhouri's news includes two recent academic publications and some exciting, innovative new projects. One of his publications, the EDICT trial, contrasted two sets of T2D patients that were treated with different regimens. One set was treated with a "classic" regimen...
2022-04-211h 02Surfing the MASH TsunamiS3-E19.3 - NAIL-NIT: What Naim Alkhouri and Jörn Schattenberg Plan for Retrospective AnalysisThis conversation starts with Naim Alkhouri and Jörn Schattenberg defining the wealth of data resources and hypotheses they are bringing to their roles as co-leads of retrospective analysis for NAIL-NIT. Mazen Noureddin then asks each of them to describe his "passionate first project." This leads Naim to discuss drug evaluation principles he finds so counterproductive that they fit into Nassim Taleb's definition of "IYI" ("Intellectual Yet Idiot"). As the discussion ends, Roger Green ties this issue to the analytical fallacy of quantifying a soft qualitative measure for drug evaluation purposes and Mazen points out that we will need t...
2022-04-1612 minSurfing the MASH TsunamiS2-E55 - Day Three at the 2021 TLMdX From AASLDProfs. Scott Friedman and Michelle Long, Dr. Naim Alkhouri and Global Liver Institute DIrector of Global NASH Programs Jeff McIntyre join Louise Campbell and Roger Green to review some of the most important and exciting presentations from the first three days of the 2021 TLMdX, the annual meeting from AASLD.Description: Each panelist chose 1-2 presentations or posters from the 2021 TLMdX from AASLD that they thought conveyed a major topic or question in the meeting. The group discussed each paper, sometimes moving far afield the original topic. As usual with SurfingNASH, conversations were interspersed with challenging i...
2021-11-151h 46
Clinical Liver Disease17-6: Artificial Intelligence in Nonalcoholic Fatty Liver Disease: A New Frontier in Diagnosis and TreatmentAudible Article by Pankaj Aggarwal and Naim Alkhouri
2021-10-0909 minSurfing the MASH TsunamiS2-E47 - Ask Opinion Leaders: The Biggest NAFLD/NASH Stories of SummerIan Rowe, Michelle Long and Manal Abdelmalek reveal what they consider the most important NAFLD/NASH stories of summer.Which NAFLD/NASH stories did they choose? The newly-appointed Professor Rowe discusses the importance of the FDA approval of the ELF test as a prognostic for cirrhosis. True to her epidemiological background, Professor Long reviews the prospective prevalence study that Stephen Harrison, Naim Alkhouri and others conducted in San Antonio. Finally, Professor Abdelmalek uses a comment she received at a presentation this summer as a jumping-off point to discuss potential value currently available generic drugs...
2021-09-241h 13Surfing the MASH TsunamiS2-E39.2 - 20K Celebration Interviews With Stephen Harrison and Naim AlkhouriThis week's celebration podcast featured interviews including seven of our favorite Surfers. In this week's conversations, we are publishing the interviews in full. Second up: Stephen Harrison and Naim AlkhouriLouise Campbell and Roger Green interview SurfingNASH co-founder Stephen Harrison and Naim Alkhouri, who Roger describes in this conversation as an "idea fountain." Stephen shares his delight at how this podcast has exceeded his initial expectations, dishes on why the chemistry between the three main Surfers works so well, and tosses out hints for the future. Naim suggests new ideas for programming while telling about...
2021-07-3144 minSurfing the MASH TsunamiS2-E25 - How many Americans Are Living with NAFLD and NASH?Study co-authors Stephen Harrison, Naim Alkhouri and Samer Gawrieh suggest that current estimates of NAFLD and NASH populations in the US may be meaningfully understated.Earlier this year, Drs. Harrison, Alkhouri, Gawrieh and seven co-authored published a paper in the Journal of Hepatology titled, "Prospective evaluation of the prevalence of non-alcoholic fatty liver disease and steatohepatitis in a large middle-aged US cohort." This study of 664 non-symptomatic patients revealed a 38% incidence of NAFLDand 14% incidence of NASH. While there were no cases of cirrhosis, 5.9% of patients demonstrated biopsy-diagnosed F2 or F3 NASH. Incidences were higher in several...
2021-05-1354 minSurfing the MASH TsunamiS2-E22 - Day Two at the 4th Global NASH Congress -- many New Drugs and Non-Pharmacologic InterventionsNaim Alkhouri, Ian Rowe and GenFit Global Diagnostics Leader Suneil Hosmane join Louise Campbell and Roger Green to review presentations from Day Two at the 4th Global NASH Congress.On April 29, over 175 NASH stakeholders from across the globe met virtually to hear 20 presentations from leaders in academia and industry. SurfingNASH selected 9 presentations to discuss in a session recorded right after the conference concluded. When the five panelists got together, the discussion extended to 90 minutes...too long for a single episode.Episode 22 features Naim Alkhouri and Louise Campbell discussing featured presentations on genomics, transcriptomics a...
2021-04-3042 min
Surfing the MASH TsunamiS2 E6.3 - #RealTalk: Trial Recruiting Challenges: Traps to Avoid in designing patient protocols for NASH TrialsThree experience NASH trial site execs identify at least 11 specific things to consider when designing your trial protocols.Stephen Harrison challenges colleagues Naim Alkhouri and Rashmee Patil to identify a "Top Ten" of criteria to consider/pressure test in designing protocols...and they come up with at least 11!In the end, Naim Alkhouri advocates for sponsors talking to trial sites, not simply CROs, during the design phase. Rashmee Patil highlights the importance of educating patients and Stephen Harrison returns to the idea of designing trials that are "Good, not great". There is a w...
2021-02-1424 min
Surfing the MASH TsunamiS2 E6.1 - #RealTalk: Trial Recruiting Challenges: Daunting Numbers and Challenging ProtocolsNaim Alkhouri and Dr. Rashmee Patil of the South Texas Research Institute join the Surfers to discuss misconceptions about the ease of recruiting and qualifying patients for NASH clinical trials.Exciting Phase 2b results over the last few months will increase demand for patients to include in NASH clinical trials. So will the recent FDA white paper and webcast, which focused on larger populations for safety evaluation. This week, SurfingNASH discusses why finding these patients will require focus, discipline and perhaps a new way of thinking about trial recruitment. Drs. Naim Alkhouri and R...
2021-02-1315 minClinical Liver DiseaseAn update on the pharmacological treatment of nonalcoholic fatty liver disease: Beyond lifestyle modificationsAudible Article by Naim Alkhouri and Andrea Scott
2018-05-2809 minClinical Liver DiseasePutting It All Together: Noninvasive Diagnosis of Fibrosis in Nonalcoholic Fatty Liver Disease in Adults and ChildrenInterview with Naim Alkhouri, M.D.
2017-12-1305 minClinical Liver DiseasePutting It All Together: Noninvasive Diagnosis of Fibrosis in Nonalcoholic Fatty Liver Disease in Adults and ChildrenAudible Article by Naim Alkhouri, M.D.
2017-12-1309 min