Fibrotic MASH resolution index to diagnose fibrotic MASH resolution and predict LREs: a global multicenter study
Feng, Gong Boursier, Jerome Saint Loup, Marc de Yilmaz, Yusuf Takahashi, Hirokazu Isoda, Hiroshi Song, Sherlot Juan Chan, Wah-Kheong Liu, Wen-Yue You, Hong
Feng, Gong
Boursier, Jerome
Saint Loup, Marc de
Yilmaz, Yusuf
Takahashi, Hirokazu
Isoda, Hiroshi
Song, Sherlot Juan
Chan, Wah-Kheong
Liu, Wen-Yue
You, Hong
Affiliation
Xi'an Medical University; Angers University; Angers University Hospital; Recep Tayyip Erdoğan University; Saga University Hospital; Saga University; The Chinese University of Hong Kong; University of Malaya; First Affiliated Hospital of Wenzhou Medical University; Beijing Friendship Hospital; Capital Medical University; University of Palermo; Nanfang Hospital; Southern Medical University; The First Affiliated Hospital of Xinjiang Medical University; Clinical School of the Second People's Hospital; Tianjin Medical University; Qingdao Municipal Hospital; Qingdao University; Xiamen Hospital of Traditional Chinese Medicine; University of Turin; Karolinska Institutet; Karolinska University Hospital; Hospital Universitario Puerta de Hierro Majadahonda; Singapore General Hospital; Virgen Del Rocío University Hospital; Virginia Commonwealth University; Xinhua Hospital; Shanghai Jiaotong University; Université Paris Cité; Assistance Publique-Hôpitaux de Paris; Beth Israel Deaconess Medical Center; Harvard Medical School; Yonsei University; Ruijin Hospital; Shanghai Jiao Tong University; The Fifth Affiliated Hospital; Guangzhou Medical University; General Hospital of Ningxia Medical University; The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University; The Second Hospital of Nanjing Affiliated to Nanjing University of Chinese Medicine; Guangdong Provincial Hospital of Traditional Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine; Beijing Youan Hospital; The First Affiliated Hospital of China Medical University; West China Hospital; Sichuan University; Beijing Ditan Hospital; The First Affiliated Hospital; Sun Yat-sen University; Hangzhou Normal University Affiliated Hospital; Drum Tower Hospital Affiliated to Nanjing University Medical School; Sir Run Run Shaw Hospital; Zhejiang University; Helwan University; Applied Science Private University Amman; Steatotic Liver Disease Study Foundation in Middle East and North Africa (SLMENA); National Hepatology & Tropical Medicine Research Institute (NHTMRI) Cairo; The Third Affiliated Hospital of Sun Yat-sen University; All India Institute of Medical Sciences; Beijing TianTan Hospital; Beijing Hospital; Linköping University Hospital; Ehime University; Westmead Hospital; University of Sydney; King Saud University; Mayo Clinic; University of Minnesota; Sir Charles Gairdner Hospital; The University of Western Australia; North Shore University Hospital/Northwell Health; Echosens Paris; University Hospitals Birmingham NHS Foundation Trust; University of Birmingham; No. 983 Hospital of Chinese People's Liberation Army; University of Verona; Don Calabria Hospital; University Hospital Southampton NHS Foundation Trust; University of Southampton; The First Affiliated Hospital of Xi'an Medical University; Royal Free London NHS Foundation Trust; University College London; Yokohama City University; University Hospital of Bordeaux; King's College London; King's College Hospital NHS Foundation Trust; The First Affiliated Hospital of Wenzhou Medical University
Other Contributors
Publication date
2025-12-22
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Background: Non-invasive assessment of improvement in fibrotic metabolic dysfunction-associated steatohepatitis (MASH) is an important clinical problem. We aimed to develop and validate the fibrotic MASH resolutionVCTE index, a non-invasive tool for identifying fibrotic MASH resolution and predicting liver-related events (LREs).
Methods: We collected data from 2,017 individuals who had two liver biopsies, separated in time, across 40 centers in the first dataset. This dataset included two independent cohorts, which were used to develop and externally validate the tool (including the baseline and change in acFibroMASH index plus change in serum alanine aminotransferase levels). The second independent dataset, comprising 17,949 patients who underwent vibration-controlled transient elastography (VCTE) at 16 centers, was used to examine associations between the developed index and the risk of incident LREs.
Findings: After application of the inclusion and exclusion criteria, 252 and 8,752 patients were included in the first and second datasets, respectively. The fibrotic MASH resolutionVCTE index accurately identified fibrotic MASH resolution with an area under the receiver operating curve (AUROC) of 0.82 (95% CI 0.74-0.90) in the derivation cohort and 0.80 (95% CI 0.72-0.88) in the validation cohort. Patients with a fibrotic MASH resolutionVCTE index >0.61 had a substantially lower risk of incident LREs than those with an index <0.24 (adjusted-hazard ratio 0.043). The index achieved AUROCs of 0.86 and 0.87, respectively, for predicting the 5- and 10-year probability of not developing LREs.
Conclusions: This global multicenter study suggests that the fibrotic MASH resolutionVCTE index may offer a non-invasive approach to estimate fibrotic MASH resolution and stratify long-term risk of LREs.
Citation
Feng G, Boursier J, de Saint Loup M, Yilmaz Y, Takahashi H, Isoda H, Song SJ, Chan WK, Liu WY, You H, Tong X, Petta S, Pennisi G, Chen J, Zhou L, He F, Fan X, Mi Y, Xu L, Xin Y, Liang H, Mi M, Bugianesi E, Hagström H, Calleja JL, Boon-Bee Goh G, Gallego-Durán R, Sanyal AJ, Fan JG, Castéra L, Lai M, Romero-Gomez M, Kim SU, Ye F, Xie Q, Wang X, Wu C, Sheng H, Wang J, Yang YF, Chi X, Xiao H, Zhang J, Wang B, Bai L, Xie W, Zhong B, Ye J, Shi J, Bi Y, Li J, Zhu Y, El-Kassas M, Emadeldeen M, Deng H, Shalimar, Aggarwal S, Zhang Z, Li M, Bai R, Song J, Kechagias S, Hiasa Y, Miyake T, George J, Sharma K, Alswat K, Al-Hamoudi WK, Abu Dayyeh BK, Bazerbachi F, Adams LA, Satapathy SK, Dayal B, Li XC, Lin H, Lee HW, Cheuk-Fung Yip T, Fournier-Poizat C, Lai-Hung Wong G, Armandi A, Shang Y, Llop E, Teh KK, Lara-Romero C, Asgharpour A, Mahgoub S, Sau-Wai Chan M, Canivet CM, Zhang S, Targher G, Byrne CD, He N, Tsochatzis E, Yoneda M, Nakajima A, de Lédinghen V, Newsome PN, Wai-Sun Wong V, Zheng MH; VCTE-Prognosis Study Group; Paired Liver Biopsy Group. Fibrotic MASH resolutionVCTE index to diagnose fibrotic MASH resolution and predict LREs: A global multicenter study. Med. 2025 Dec 22:100929. doi: 10.1016/j.medj.2025.100929. Epub ahead of print.
Type
Article