Background & Aims

Nonalcoholic steatohepatitis (NASH) is associated with an increase in healthcare resource use and poor health-related quality of life (HRQoL). We assessed the humanistic and economic burden of NASH, disease management, and patient journey.

Methods

We performed a cross-sectional analysis of data, collected from July through November 2017, from the Growth from Knowledge Disease Atlas Real-World Evidence program, reported by physicians in United States, France, and Germany. We extracted demographic and medical data from medical records. Some patients voluntarily completed a survey that provided information on disease history, treatment satisfaction, and patient-reported outcomes.

Results

We analyzed data from 1216 patients (mean age, 54.9±12.3 years; 57.5% male; mean body mass index, 31.7±6.9); 64.6% had biopsy-confirmed NASH and comorbidities were recorded for 41.3%. Treatments included lifestyle modification (64.6%) or use of statins (25.0%), vitamin E (23.5%), or metformin (20.2%). Patients with biopsy-confirmed NASH reported more physician (4.5 vs 3.7) and outpatient visits (1.8 vs1.4) than patients with suspected NASH not confirmed by biopsy. Among the 299 patients who completed the survey, 47.8% reported various symptoms associated to their NASH. Symptomatic patients reported significantly lower HRQoL than patients without symptoms.

Conclusions

In an analysis of data from 3 countries, we found NASH to be associated with regular use of medical resources; patients with symptoms of NASH had reduced HRQoL. The burden of NASH appears to be underestimated. Studies are needed to determine the burden of NASH by fibrosis stage and disease severity.

中文翻译：

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非酒精性脂肪性肝炎的真实负担

背景与目标

非酒精性脂肪性肝炎 (NASH) 与医疗资源使用的增加和与健康相关的生活质量 (HRQoL) 差有关。我们评估了 NASH、疾病管理和患者旅程的人文和经济负担。

方法

我们对 2017 年 7 月至 11 月收集的数据进行了横断面分析，这些数据来自美国、法国和德国的医生报告的知识疾病图谱增长真实世界证据项目。我们从病历中提取人口统计和医疗数据。一些患者自愿完成一项调查，提供有关疾病史、治疗满意度和患者报告结果的信息。

结果

我们分析了 1216 名患者的数据（平均年龄，54.9±12.3 岁；57.5% 的男性；平均体重指数，31.7±6.9）；64.6% 有活检证实的 NASH，41.3% 有合并症。治疗包括生活方式改变 (64.6%) 或使用他汀类药物 (25.0%)、维生素 E (23.5%) 或二甲双胍 (20.2%)。活检证实的 NASH 患者报告的医生（4.5 对 3.7）和门诊就诊（1.8 对 1.4）多于未通过活检证实的疑似 NASH 患者。在完成调查的 299 名患者中，47.8% 的患者报告了与 NASH 相关的各种症状。有症状的患者报告的 HRQoL 显着低于无症状患者。

结论

在对来自 3 个国家/地区的数据进行分析时，我们发现 NASH 与经常使用医疗资源有关；有 NASH 症状的患者 HRQoL 降低。NASH 的负担似乎被低估了。需要研究以确定纤维化阶段和疾病严重程度的 NASH 负担。