Clin Gastroenterol Hepatol. 2023 Aug 11:S1542-3565(23)00626-2. doi: 10.1016/j.cgh.2023.08.004. Online ahead of print.
ABSTRACT
BACKGROUND & AIMS: Individual risk prediction of liver-related events (LRE) is needed for the clinical assessment of NAFLD/NASH patients. We aimed at providing point-of-care validated liver stiffness measurement (LSM)-based risk prediction models for the development of LRE in patients with NAFLD, focusing on selecting patients for clinical trials at risk of clinical events.
METHODS: Two large multicenter cohorts were evaluated, 2638 NAFLD patients covering all LSM values as derivation cohort and 679 more advanced patients as validation cohort. We used Cox regression to develop and validate risk prediction models based on LSM alone, and the ANTICIPATE and ANTICIPATE-NASH models for clinically significant portal hypertension. The main outcome of the study was the rate of LRE in the first 3 years after initial assessment.
RESULTS: The 3 predictive models had a similar performance in the derivation cohort with a very high discriminative value (c-statistics 0·87-0·91). In the validation cohort, the LSM-LRE alone model had a significant inferior discrimination (c-statistic 0·75) than the other 2 models, while the ANTICIPATE-NASH-LRE model (0·81) was significantly better than the ANTICIPATE-LRE (0·79). In addition, the ANTICIPATE-NASH-LRE presented a very good calibration in the validation cohort (integrated calibration index 0·016), better than the ANTICIPATE-LRE.
CONCLUSIONS: The ANTICIPATE-LRE models, and especially the ANTICIPATE-NASH-LRE model, could be valuable validated clinical tools to individually assess the risk of LRE at 3 years in patients with NAFLD/NASH.
PMID:37573987 | DOI:10.1016/j.cgh.2023.08.004
