Send us a text

This conversation is the fourth and final segment of SurfingMASH’s April discussion of drug development in memory of Stephen A. Harrison. In addition to co-hosts Jörn Schattenberg, Louise Campbell and Roger Green, panelists include hepatologist and key opinion leader Sven Francque.

The discussion focuses on PPARs, genetic medicines, and other emerging drug classes while considering the idea that drug therapies can have an impact on the liver independent of their effect on fibrosis regression. It begins with Sven discussing his experience as a lead investigator in clinical trials for the pan-PPAR agonist lanifibranor, whose Phase 3 trial is now fully recruited. Sven states that in addition to fibrosis regression, lanifibranor is likely to exhibit other pleiotropic effects, and notes that vascular changes start early in the fibrotic progression process.

After Sven elaborates on these effects, Louise asks about the SCD-1 agent Aramchol. This leads to a discussion about the idea that over time, therapy will probably come to incorporate two separate modes of action, with one to treat the metabolic dysfunction and the other to treat specific effects in the liver or, as Jörn puts it, "combining weight-neutral and weight-reducing drugs." This evolves into a discussion of what Louise terms "personal-centric" medicine, or what patient advocate Mike Betel has previously described on SurfingMASH as "tailored medicine."

The rest of the conversation predominantly lists other classes of drugs, "safe" mitochondrial uncouplers, genetic medicines, and others. Roger inquires about the FASN inhibitors, which are entering Phase 3 clinical trials. Jörn says that the data appears positive and unique. That said, he and Sven agree we need more data.

Louise sounds the closing note for this roundtable by discussing our co-founder, Stephen Harrison, and the energy and enthusiasm he brought to the entire drug development process. The group agrees that Stephen's impact continues to be felt through the MASLD community, even as he is missed by us all.

Send us a text

Global Liver Institute President and CEO Larry Holden joins Roger Green to discuss recent Washington political and regulatory activities, their potential impact on the liver community, and ways we can respond.

Larry starts by acknowledging that we are in for "dark times" under the current administration and describes some current government actions that are causing major setbacks, as well as others that have the potential to do so. Specifically, he details the challenges caused by budget cuts, reallocation of funds away from major universities, staff reductions and, along with them, a loss of expertise in technical areas where knowledge and experience are pivotal.

Without minimizing these challenges, Larry proceeds to suggest actions that individuals and organizations can take to reduce losses to the greatest extent possible — and even create some "wins" — for people living with liver disease. He describes tactics for giving legislators something they value (mainly publicity and contacts) to build a relationship, gain access and create a sympathetic ear for liver community messages.

The conversation itself shifts back and forth between some of the current challenges and the steps advocates can take to mitigate losses and, whenever possible, achieve "wins." Sometimes discouraging, sometimes educational, this is an essential conversation for all current and potential advocates for liver patients to hear.

Send us a text

This conversation is the second segment of SurfingMASH's coverage of the Global Think Tank on Steatotic Liver Diseases (#SLDThinkTank2025) held in Barcelona in June. It focuses on the kinds of feedback most likely to produce successful behavioral interventions.

The conversation begins with Jörn discussing the Liver Screen Study, a "very ambitious effort" that starts with 30,000 members of the general European population, narrows down to a subgroup with liver disease, and then provides these individuals with information about MASLD and how to manage it, ultimately evaluating its impact. Many of these people did not know about liver disease before being informed they had it, and many changed their behavior as a result. Jörn links this to the EASL Amsterdam activity discussed last week in 6.7.1 and 6.7.2.

Louise relates a story of speaking with Laurent Sandrin, Chairman of Echosens and inventor of FibroScan, who was "blown away by the reaction" to making FibroScans available and promoting this fact. Louise explained to Laurent that from her vantage point, FibroScan is "more than just the physical diagnostic. It has the power to engage populations," and, for many, provide the information and motivation they need to change behavior. Kristina describes how we can provide "biofeedback" like this, along with other behavioral strategies, to produce sustainable behavior change, which is far harder for an individual than simply reacting to a medical scare. She describes a model she deploys, the "Combi" model, which integrates an array of informational, motivational and behavioral items into an integrated, individualized approach.

The conversation shifts to focus on environmental factors that work against long-term change. For someone with alcohol use disorder, this might be a family member who continues to consume large quantities of alcohol frequently. For someone living with obesity, it might be a favorite high-calorie dish...or even simply food advertising.

In the final part of this conversation, Jörn states that the Think Tank steering committee invited politicians to help them understand why certain kinds of interventions — such as taxing medically harmful goods or limiting advertising — might be socially valuable, even if unpopular. The group discussed some governmental tactics that are effective and others that are not.