S2-E52.4 - MRE Findings Suggest Flaws in Fibrosis As Endpoint Surfing the MASH Tsunami

 Alina Allen and Ian Rowe lead the Surfers in considering biopathological shortcomings in fibrosis as a solitary endpoint. Their comments stem from Alina's presentation of the recent Mayo Clinic paper, "MRE for Prediction of Long-Term Progression and Outcome in Chronic Liver Disease: A Retrospective Study." In this conversation, Alina summarizes the paper, after which Stephen Harrison asks questions about availability of subgroup analysis.
This conversation focuses on flaws in biopsy as a measurement device and also in fibrosis as a solitary endpoint.
In the rest of the discussion, the group discusses challenges in proving that NITs can accurate measure and differentiate between different drugs in terms of therapeutic efficacy. One challenge is with the current metrics. We speak frequently about the challenges with biopsy and with fibrosis being an ordinal variable, but as Alina notes, being too tied for fibrosis means we focus solely on one measure of improvement and downplay others, such as steatosis.
The conversation is too rich and nuanced to be captured in a paragraph or two. This episode is worth two or three listens to capture all its points.