Fibrosis progression rate and comparison of paired liver biopsy versus non-invasive tests as surrogate endpoints for clinical trials in MetALD and ALD

Key Points

• This study aims to understand fibrosis progression rates in metabolic and alcohol-related liver diseases and evaluate non-invasive biomarkers as surrogate endpoints for clinical trials.
• Included patients from two randomized clinical trials and one cohort study with excessive alcohol intake
• Performed paired liver biopsies and non-invasive testing to measure fibrosis progression
• Analyzed associations using C-statistics to compare biopsy results and non-invasive biomarkers.
• Fibrosis progression was 0.22 stages per year among 164 patients, with active drinkers progressing over two-fold faster than abstinent individuals.
• During 2.1 years of follow-up, 13% of patients decompensated or died, indicating significant clinical outcomes.
• Non-invasive biomarkers such as LiverPRO (0.78) and PRO-C3 (0.72) effectively predicted adverse outcomes, showing promise as surrogate markers.