CareNet, in collaboration with the University of Occupational and Environmental Health, Japan published a paper on "Clinical Characteristics of Non-Alcoholic Steatohepatitis (NASH) Patients in Japan”

CareNet,Inc. (Head Office: Chiyoda-ku,  Tokyo; President: Katsuhiro Fujii; URL: https://www.carenet.co.jp;) and the  Department of Public Health in the University of Occupational and Environmental  Health, Japan (Location: Kitakyushu City, Fukuoka Prefecture;) are pleased to  announce that the results of a joint study conducted with the aim of examining  the clinical characteristics of patients with Non-Alcoholic Steatohepatitis  (NASH) and associated comorbidities in Japan have been published “Clinical  characteristics in patients with Non-Alcoholic Steatohepatitis in Japan” on the  British Medical Journal "BMJ" on August 22, 2023. 

This study is a Real World Data (RWD) study  based on National Health Insurance and Elderly Health Insurance Claims Data with  eligible patients diagnosed with NASH (receipt disease name and liver biopsy  history) in the 5-year period between April 2015 and March 2020.

The key results included a comparison of patients  who met the diagnostic definition for NASH (n=545) with non-NASH controls  (n=185,264), which suggested a significantly higher in NASH patients than in the  controls. The result also indicated higher proportions of females and patients  with dyslipidemia, hypertension, GERD, and type 2 diabetes in the NASH group;  in addition, NASH was associated with an increased risk of hepatic cirrhosis  and liver cancer.

The paper concludes that in the daily  medical care of patients with NASH, close attention needs to be paid to the  risk of malignancies, including hepatic cirrhosis and liver cancer, as well as  lifestyle comorbidities, considering sex and age differences.

About NASH

Nonalcoholic fatty liver disease (NAFLD) is  the most common type of liver disease, affecting approximately 20–30% of the  global population [1]. NAFLD includes nonalcoholic fatty liver (NAFL), which is  pathologically pure steatosis alone or a situation in which steatosis is  accompanied by inflammatory cell infiltration, and nonalcoholic steatohepatitis  (NASH), which is accompanied by hepatic steatosis, inflammatory cell  infiltration, ballooning (hepatocellular ballooning), and hepatic fibrosis [2].

NASH is strongly associated with metabolic  syndrome, obesity, diabetes mellitus (DM), hypertension, and dyslipidemia, and  the major causes of death are cardiovascular and liver-disease-related  events[3]. However, the biopsy rate for NASH diagnosis is low, and NASH is  underdiagnosed[3]. According to an estimate based on a Markov model of the  number of patients with NAFL and NASH worldwide, the number of patients with  fibrotic NASH at stage III or higher in Japan was 660,000 in 2016, and  predicted to increase to 990,000 by 2030[4]. Moreover, although NASH prevalence  has been estimated at approximately 3–5% of the population[5,6], there is  insufficient evidence regarding the NASH prevalence in the general population  due to selection bias in liver biopsies and diagnostic difficulties.

About the paper

Title: Clinical characteristics in patients  with nonalcoholic steatohepatitis in Japan: A case-control study using a 5-year  large-scale claims database

Author(s):

Kei Tokutsu, Kaoru Ito, Shigeki Kawazoe,  Sota Minami, Kenji Fujimoto, Keiji Muramatsu, Shinya Matsuda

Journal: BMJ

DOI: 10.1136/bmjopen-2023-074851: external  link

Reference

1. Cotter TG, Rinella M. Nonalcoholic Fatty  Liver Disease 2020: the state of the disease. Gastroenterology 2020;158:1851-64.  doi:10.1053/j.gastro. 2020.01.052

2. Tokushige K, Ikejima K, Ono M, et al.  Evidence-based clinical practice guidelines for nanalchoholic fatty liver  disease/nonalcholic steatophepatitis 2020 (2nd Edition). Hepatol Res  Gastroenterol 2020;56:951-63. 3.

3. Chalasani N, Younossi Z, Lavine JE, et  al. The diagnosis and management of nonalcoholic fatty liver disease: practice  guidance from the American Association for the Study of Liver Diseases.  Hepatology 2018;67:328-57. doi:10.1002/hep.29367

4. Estes C, Anstee QM, Arias-Loste MT, et  al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan,  Spain, United Kingdom, and United States for the period 2016-2030. j Hepatol  2018;69:896-904. doi:10.1016/j.jhep.2018.05.036

5. Williams CD, Stengel J, Asike MI, et al.  Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis  among a largely middle-aged Gastroenterology 2011;140:124-31.  doi:10.1053/j.gastro.2010.09.038

6. Vernon G, Baranova A, Younossi ZM, et  al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic  steatohepatitis among a largely middle-aged Aliment Pharmacol Ther  2011;34:274-85. doi:10.1053/j.gastro.2010.09. 038

About CareNet, Inc.

Name: CareNet Co.

Representative ：Katsuhiro  Fujii, President and Representative Director

Location ：Sumitomo  Fudosan Chiyoda Fujimi Building, 1-8-19 Fujimi, Chiyoda-ku, Tokyo

Establishment ：July  1996

Capital ：2,405  million yen

Main Business：Pharmaceutical  sales support services for pharmaceutical companies,

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