madrigal

Vance was the 2022 ACC Tournament MVP and league Preseason Player of the Year, but he joins us to talk about his defense and his penchant for home run-robberies and other great catches. He also explains how he's evolved as a hitter, one who could be a high-end pick in next year's MLB Draft (0:42).

Ben writes a weekly column about "5 Things He Likes About Baseball", and we modify that slightly to have Ben and Mark talk about 3 things they each liked about MLB defense from the first month of the season. Among the subjects, an outfielder with a cannon arm in Cleveland, how Wilmer Flores made a play with a 5% out rate, and why Ke'Bryan Hayes should be viewed as great by Cardinals fans (11:25).

Thanks as always for listening. Please follow us on Twitter at @sis_baseball and read our work at SportsInfoSolutions.com. You can e-mail us at Mark@sportsinfosolutions.com.

Last week, roughly 5,000 liver community stakeholders gathered in London for the 2022 International Liver Congress (#ILC2022,) the first major hepatology Congress to be held in person since the start of the pandemic (smaller, but very valuable, meetings like NASH-TAG, LiverCONNECT and Paris NASH have taken place with an in-person component, but the International Liver Congress and The Liver Meeting have not). On the last full day of the program, several vitally important drug development studies were presented during the late-breaker and dedicated sessions. The conversations in this episode will review some of the most important findings. This particular conversation focuses on the semaglutide cirrhosis late-breaker and, more broadly, what panelists consider the presentation from this Congress most likely to effect change over the next 2-3 years.

Because Stephen Harrison needs to depart, the episode starts with him answering a question about the most consequential paper in the Congress. He focuses on the resmetirom late-breaker, which presages potential drug approval within the next 18 months. Jörn Schattenberg takes a different tack, identifying the semaglutide cirrhosis late-breaker instead. Jörn notes that the study did not achieve its primary endpoint of 1-level fibrosis reduction in 48 weeks, but cites other studies and experiences to suggest this is very, very hard to achieve for any drug. Jörn continued to suggest that semaglutide's safety level combined with the ability to help patients lose weight and reduce their HbA1c levels means this can be a valuable drug for Fatty Liver patients as well as diabetics and people with obesity, the currently indicated patient populations. 

From here, the group provides answers to the "most consequential presentation" question and the conversation comes to an end.

With a special guest, Jibril aka Stixxx82 (Xbox), we discuss the Paramount Plus version of the Halo world and how it matches up to our expectations and comparisons to the video games and books.

Thanks for listening! Follow us on Twitter (@3HokagesPodcast) & Instagram (@3Hokages).

Pop your popcorn because it's movie night on this week's episode of the podcast as we talk about the smash hit Encanto! What's all the hype about and why is no one talking about this  Bruno guy? Bryn and Laura review one of Disney's latest while breaking down the progression of messaging that is now being geared towards the children of today's day and age. What is transgenerational trauma and why does it have such a lasting effect on the future of our families? Bryn talks about some of the pressures that can come from feeling like you have to constantly make your family feel proud while Laura highlights some of the ways even us non magic folk can find our inner gifts out here in the real world. So join us as we talk about Bruno and embrace the magic that is Encanto, the movie. 


Music Credit: Ready for This by Dan Phillipson (Into / Outro)

Program co-chairs Jeff Lazarus and Jörn Schattenberg join the Surfers to discuss their "Innovations in NAFLD Care 2022" series and how it promotes the broader NAFLD Public Health Agenda.

This far-ranging discussion focuses on the Innovations in NAFLD Care 2022 webinar and event series with the goal of understanding what makes this series special and why it is so important today. The NAFLD Public Health Agenda is challenged with high prevalence levels, year-on-year double-digit increases in the number of newly-diagnosed cirrhosis patients, worsening of diets and exercise regimens brought about by the COVID-19 pandemic and an array of issues stemming from the lack of efficacious and tolerable medicines approved for this indication.

Global Liver Institute Founder and CEO Donna Cryer and Key Opinion Leader Professor Scott Friedman joined Roger Green at NASH-TAG 2022 for a far-reaching conversation on drug development and scientific advances in Fatty Liver disease.

This episode includes the entire discussion, plus a shorter one with Roger and  SurfingNASH co-host Louise Campbell on some of the lessons emerging from NASH-TAG's first day.

Timestamps: 
2:17 – Roger Green introduces the agenda for today’s episode
5:42 – Donna Cryer: “Favorite phrase” from the NASH-TAG Day 1 is “lessons learned”
7:02 – Scott Friedman on NASH-TAG Day 1: equal parts sobering and promising, with a major conceptual change
7:34 – Scott’s “sobering” points: highly anticipated clinical trials “did not pan out;” “we don’t know where this disease starts” or where to start treating it; and “we tend to approach the disease as one size fits all”
9:06 – Scott’s “promising” points: digital histopathologies, gene regulation and epigenetics, diagnostics, organoid technologies and more
11:33 – Roger: We need to think of “combination” treatment strategies not only as static same-time combinations but also sequencing of medications as replacements or add-ons 
12:58 – Donna: To de-risks trials, include patients throughout objective setting and trial design
14:42 – Roger: Patient feedback may provide greater value to smaller companies with less margin for error
15:28 – Scott: Another consideration is patients’ disappointment "when things don’t work.”
16:20 – Donna: Patients realize the first drug “doesn’t have to be perfect”
17:13 – Donna: Interdisciplinary discussions at NASH-TAG are a very hopeful development
18:04 – Scott: We have a great deal to learn about underlying biology, but the efforts to do so make me hopeful
19:10 – Scott: Weight loss reverses a biology we can’t seem to accomplish with NASH drugs, which is promising
20:18 – Donna: We need multidisciplinary, multifaceted complete care approaches that do not rely on patients’ willpower and work for different types of patients
22:24 – Scott: “Personalizing” is not just about therapy, but also how the patient copes with the disease
23:02 – Donna: I remember early in my care being jealous of cancer patients for the holistic care they were able to receive that liver patients weren’t
25:55 – Donna: Will pruritis continue to be an ultra-rare indication when it exists with so many liver diseases?
26:25 – Scott: New, more elegant biologic definition of pruritis processes should lead companies to develop better therapies
28:59 – Donna: When they are approved, NASH drugs will be prescribed in as polypharmacy.  Patients have multiple healthcare costs. I hope manufacturers will act responsibly
30:14 – Donna: Pricing for pruritis agents might inspire a backlash. Patient advocates will not support current pricing
31:01 – Roger: Keep in mind that modeling comes from finance departments and targets cash management and budgeting issues
31:34 – FINAL QUESTION: What do you believe will change and hope will change in the next year?
31:40 – Scott: Hope to see a drug trial result that will points to approval. Expect to see advances in NITs and digital histopathology
32:41 – Donna: Hope and expect two things: alignment between advocates, researchers, manufacturers and regulators on what mark we need to hit and what will happen once we hit it, and clarity around best use of NITs
33:31 – Roger: Expect to see adoption of digital histopathology in 23, maybe even end of next year. Hope to see widespread acceptance that stabilizing fibrosis is a perfectly acceptable clinical outcome for drugs
34:33 – Scott: We’ve known all along that FDA considers non-progression from advanced fibrosis to cirrhosis an acceptable endpoint
36:03 – Louise and Roger chat about fine points from NASH-TAG sessions and the first part of S3 E2
45:55 – Business Sect

SurfingNASH invited four attendees to the NASH-TAG wrap up (three first-timers, two corporate executives) to focus on presentations and discussion from the fireside chats. Highlights include:
4:20 – Introduction of first-time panelists Amy Articolo (Novo Nordisk), Erin Quirk (Terns Pharmaceuticals), Rachel Zayas (AGED Diagnostics) and the returning Ian Rowe (University of Leeds)
12:55 – Opening question: what about NASH-TAG 2022  surprised you most?
13:04 – Consensus: energy and passion. Rachel mentioned the vast divergence in  balloon hepatocyte readings
16:19 – Led by Stephen, group discusses powerful single slides
22:51 – Question: What single presentation had a real impact on your thinking?
23:04 – Rachel: Single Cell Transcriptomics, which can identify disease drivers.
25:53 – Ian: Scott Friedman’s point about the need to balance blocking fibrosis with maintaining sufficient collagen for scar healing.
27:16 – Amy: Talks about upstream effects resonated because Novo Nordisk works to develop combination therapies.
28:53 – Erin: One “pleasant takeaway” was big companies sharing findings “shoulder to shoulder” with smaller ones.
30:04 – Roger: Rate reaction to fireside chats using 6-point scale. Erin, Amy, Rachel all say 5. Liked diverse viewpoints, high energy level. Ian says 4, maybe 3. Fears that following the path laid out in meeting will lengthen drug development.
36:06 – Stephen: We need to improve use of histopathology, design and implement a multi-year path to NITs as outcome drivers and develop NAIL-NIT, a multi-company, “agnostic” data repository to utilize everyone’s data to “ask the big questions” and drive large prospective trials. Also, we should provide analytics and perspective on unresolved issues that are delaying final FDA guidance document
47:02 – Amy: Key is to impact patients’ lives, which is more “function and feel,” less survival. We’ll look back on this as "The moment of change”
48:59 – Roger: FDA has becoming more open and encouraging since 01/21 webcast
50:33 – Roger: Stephen’s push to lower screen fail rates from 80% to 50% will drive 2.5x increase in eligible patients, thus shortening trials, reducing costs
52:35 – Stephen: This can also reduce placebo response rates, which are a major issue in interpretation
54:27 – Erin: Should we even be looking at liver tissue when pathologists are so mislaligned on balloon hepatocytes? Stephen: Eventually, perhaps not. But the ongoing trials today have to rely on histology
55:02 – Erin: Are we creating medications that patients actually will want to take, given that many choose not to participate in trials? Louise: Decision is individual, but those who take time to make it wisely have the greatest prospects for success
57:14 – Ian: Findings from trial populations and natural history populations can vary widely. Also, the NITs we use in trial need to work financially for the larger population
59:20 – Amy: Expanding trial population into primary care or OB/GYN would broaden target dramatically
1:01:02 – Question: something you hope to see that is different in a year and something you believe you will see
1:01:14 – Louise: Patients and advocates at future Fireside chats
1:01:29 – Rachel: Tests that look separately at the different NAS elements instead of creating composite scoring
1:02:02 – Erin: A positive Phase 3 study result
1:02:31 – Amy: Solid and actionable programs to create solutions to issues identified this past weekend
1:03:03 – Ian: Expect positive Phase 3 data. Hope to see discussion around NITs that correlate consistently with histology and drive changes in outcomes
1:03:21 – Stephen: Hope to report positive Phase 3 trial
1:05:04 – Roger: Believe AI histopathology will play larger role; hope this entails more than simply emulating human brain 
1:08:03 – Busines

In advance of NASH-TAG 2022 this weekend, Jörn Schattenberg joins the Surfers to answer a key conference question: are we ready to pivot toward non-invasive tests and better uses of histopathology? The group explores a range of questions and ideas that are likely to emerge during Saturday night's fireside chats.

The group explores a range of questions and ideas that are likely to emerge during Saturday night's fireside chats.

 Highlights include:
7:03 – Stephen Harrison begins to discuss NASH-TAG 2022
7:45 – Jörn Schattenberg: we’re not ready to move beyond biopsy in 2022. Hope that we will bring forward the right program by end of year
8:31 – Roger agrees
8:43 – Stephen agrees, but looks to determine how to resolve pivotal challenges
9:46 – Stephen lists discussants for the fireside chats, including regulators, researchers and industry representatives
10:30 – Stephen lists  key topics for his talk on non-cirrhotic trial endpoints
11:37 – Stephen lists “hurdles” biopsy  "needs to overcome" 
12:40 – Stephen’s key issue for histopathology : why we only score one H&E and one tri-chrome read per sample. He suggests three H & E and promises to reveal data on this in his talk.
15:08 – Jörn: "Why three?” 
16:08 – Stephen: no magic, three non-contiguous reads “just makes sense.” The goal is to is to find ballooned hepatocytes or clustering, which might not appear in one slide but will frequently elsewhere in the sample.
18:11 – Stephen: choose the slide with the strongest presence of disease
18:47 – Key benefit: we screen fail fewer people on ballooned hepatocytes
19:59 – Potential secondary benefit: reducing resolution scores in the placebo group
21:09 – Stephen: three companies looking at this. All see a major difference.
21:29 – Stephen: there are commercial issues as well: high screen fail rates inflate costs and take lots of time. This approach will save money and time.
24:13 – Stephen: I like Jörn’s idea about using AI here. It will enhance reproducibility.
24:52 – Stephen: another issue is the shift from one to multiple pathologists. Multiple pathologists turns out to drive screen fail rate higher. We need something to counter that.
26:49 – Louise Campbell: getting more tissue is beneficial for the patient
27:52 – Louise: a lot of NIT evaluation comes from pairing to biopsy samples. The more samples, the more opportunity to test NITs.
29:14 – Stephen shifts to getting beyond the biopsy. FDA issue: link an NIT to outcome. The cirrhosis chat gives us our first shot on goal.
30:55 – Stephen: one challenge with non-cirrhotics is that NITs are not included in the major Phase 3 trials
32:07 – Jörn: this is a pivotal issue and NASH-TAG is the right place to discuss it
33:33 – Louise: consider quality-of-life as a high value outcome measure
33:57 – Jörn: how do we explore stabilization of disease with NITs?
34:31 – Stephen: all these are reasons to “set the stage” with cirrhotic cohorts first, learn the lessons, then extend to non-cirrhotics
37:56 – Closing question: what will make 2022 successful to you in terms of moving this agenda forward?
38:17 – Jörn: data from the consortia
38:50 – Stephen: a clear idea of what will get us to a surrogate endpoint with NITs. Until then. improve histopathology practices.
39:54 – Louise: anything with histopathology that leads us toward NITs is good. Also, we will need to do more remotely as long as COVID keeps rearing its head.
40:51 – Roger: let’s learn more and make two cases one on economics and the other on data quality
41:17 – Stephen: one more thing: better economics and stronger data will motivate Big Pharma to invest
43:53 – Stephen: at the end of the day, it’s all about economics
44:53 – Roger: burnt money feels wasted, makes study investment feel like an expense
46:09 – Stephen: listen for more Saturday night
47:16 – Business report

This conversation is part of SurfingNASH's 2021 NAFLD Year-In-Review. Co-host Dr. Stephen Harrison joins Louise Campbell and Roger Green to review five key NASH themes that emerged in 2021, while simultaneously discussing the year for Surfing the NASH Tsunami.

It seems fitting that the first SurfingNASH event of 2022 should include Stephen, Louise and Roger. In this thoughtful, fast-moving conversation, Stephen identifies what he considers five key areas where the Fatty Liver community has progressed in the past year:
1. Call to action -- 2021 saw two separate, vitally important calls to action to share the scope of the upcoming NASH pandemic with the medical community at large and begin to create forums and processes to develop an agenda and care practices that would reach far beyond hepatolotgy all the way to primary care and other specialties that have historically had little to do with the liver. Jeff Lazarus work with colleagues at Wilton Park and in over 100 countries to evaluate the current status of NASH diagnosis, treatment and screening around the world and to being developing a public health agenda. At around the same time, a multidisciplinary panel of US opinion leaders organized by AGA published a general call to action and a specific Clinical Care Pathway, starting at diagnosis, that included multiple specialties and, for the first time, set out to define a way specialties can work together in identifying patients at risk, screening them for disease, and then treating as appropriate.
2. Natural History -- 2021 saw publication of two major papers on the natural history and progression of the disease. One paper produced by Stephen, Naim Alkhouri and a range of associates, evaluated a large group of seemingly healthy middle-aged men who receive treatment at the San Antonio Military Medical Center and mirrored a smaller study 10 years earlier. The two studies were fairly consistent in determining that slightly over one adult in three has demonstrable NAFLD and one in seven or eight has documentable NASH. The difference in the populations was that while approximately 2% of the 2011 sample exhibited F2 or F3 NASH, that number almost tripled ten years later. These papers and Dr. Arun Sanyal's work published later in the year in the New England Journal of Medicine indicated that we can project a steadily increasing trend line for cirrhosis cases, with growth in most major markets at 10-12% per year.
3. Drug Development --news here was mixed, although Stephen points out that we have learned from each failed trial. SurfingNASH discusses this topic frequently, so suffice it to say that as the year ends, three medications recruiting or conducting Phase III trials and several other exciting, innovative agents have already demonstrated some positive Phase II results.
4. Weight loss surgery -- Stephen feels that the SPLENDOR study, which we discussed recently on the podcast (S2 E60), merits notice because of what it suggests about the ability of dramatic weight loss to halt or reverse cirrhosis. There are drugs in development right now that appear capable of producing the same levels of weight loss shown with bariatric surgery, which provides hope that we can eventually stabilize and perhaps regress fibrosis levels in cirrhotic patients.
5. Non-invasive testing -- Several different modes of non-invasive testing have made progress during the year, ranging from liquid tests that received FDA approval and/or enhanced their commercialization capabilities to published research suggesting that MR Elastography (MRE) has compiled much of the data necessary to prove outcomes with greater clarity and confidence than biopsy. Stephen shared his belief that 2022 will be the year when academics, drug developers and regulators begin to align around a strategy to move beyond biopsy with deliberate speed.

None of these items are new, but the way Stephen organizes them is clearly worth a long listen.

The last half of December marks our annual NAFLD Year-in-Review. Episodes 62-64 each include ~20 minute segments of longer interviews with Stakeholders who have made a dent in Fatty Liver disease in 2021. In this episode, Louise Campbell and Roger Green are joined by Manal Abdelmalek, Kenneth Cusi and Jörn Schattenberg.

Highlights:
3:26 – Manal Abdelmalek introduction and discussion: opportunities in the new drug pipeline and ways to treat using older agents until new agent arrive
5:06 – Manal: urgent to treat cirrhosis when it appears. Reversal may not be “achievable;”  but blunting progression can provide stability 
9:51 – We learn more about heterogeneity of cirrhosis patients all the time. Some day, genetics will pinpoint each patient's outcome to avoid so we can treat accordingly
12:20 – Louise: would a combined database of multiple cirrhosis drug study patients provide richer insights?
14:05 – Manal: let’s “shelf,” not "trash," drugs that had promising NIT results but missed in Phase 2b or 3 histology
18:57 – Louise: Manal does well to remind us how to use older drugs to stabilize cirrhosis patients.
21:05 – Manal: until new drugs become commercially available in 2-5 years, using older drugs better will be key
23:07 – Ken Cusi introduction and discussion: development of multi-disciplinary activities and clinical care pathways
24:10 – Ken: New data on prevalence and etiology of NASH cirrhosis spurred multi-specialty activities
24:41 – Key insight drivers: NHANES analyses, endorsements from medical societies and global journals, work of Jeff Lazarus and Wilton Park
27:01 – 2022 a “great year:"  new/updated guidelines, major Phase 3 trials progressing
 30:00 – Louise:  AGA critical care pathway work and collaboration among specialties pivotal, positive and extending to related consumer industries
 31:26 – Ken: 2-3 years from now, foresees “convergence of awareness” to expand FIB-4 and other simple tests to more patient risk subgroups.
33:25 – Study in progress: screening large number of patients to determine NASH prevalence among non-diabetic patients
35:34 – There was significant debate whether to include screening for T2D patients in  the 2018 AASLD guideline recommendations
37:03 – Louise: Fatty Liver disease has far broader implications than simply for the liver
38:41 – Roger: asks how liver testing and vigilance will fit in  schedules and practices of already overburdened providers
39:55 – Ken:  requires a of simple, inexpensive, easily accessible  Stage 1 tests like FIB-4, was key to its selection
42:22 – Jörn Schattenberg introduction and question: how are cost effectiveness analyses progression
44:25 – Jörn: 2021 has been “an exceptional year” for NASH
46:04 – Collaborated with Vlad Ratziu and others to produce cost of illness study published in Liver International in 2021
49:39 -Louise:  why does it feel like we study cost effectiveness only for expensive new drugs and never measure cost effectiveness of inaction?
50:38 – Jörn: value of monitoring relies on measuring related risks from cardiovascular and other systems
52:22 – Roger:  re Louise’s question, most cost effectiveness work evaluates a specific new expenditure, not a global “what if”
55:44 – Jörn: quality-of-life, which has clear economic costs, strongly associated with NAFLD
57:14 – Roger: Using HER to identify patients at risk might be a more palatable way to target education and information
59:50 – Jörn: An Optum database algorithm built by NIDDK provides a look at how to target
1:01:09 – Episode ends

Manal Abdelmalek, Jörn Schattenberg and Ian Rowe join regulars Stephen Harrison, Louise Campbell and Roger Green to recap NAFLD and NASH-related insights from the 2021 , the AASLD annual liver meeting. This conversation focuses on complexities and challenges NAFLD drug development and patient treatment will face in the future and ends with predictions about the biggest stories of the 2022 Liver Meeting (hopefully hybrid instead of only digital!).

The specific complications include microbiome, which has the potential to add a regional (or even individual) component to our understanding of NAFLD. Stephen Harrison speculates on how the scarcity of MRE machines will affect patient diagnosis if MRE becomes the dominant method for diagnosing/staging NASH and Roger Green notes that the advances in disease analytics and modeling have all resulted from continuing improvements in the quality and cost effectiveness of generating and analyzing data. Finally, panelists state when they expect to be the big story of the 2022 TLM, with the group divided evenly between those looking to Phase 3 results from ongoing trials and those who believe that the increasing presence of the patient viewpoint will drive significant changes in every element of how we diagnose, stage and treat patients in the future.

Seven of our favorite Surfers join together to celebrate 20,000 Buzzsprout downloads and our one-year anniversary of moving to Buzzsprout.

Louise Campbell and Roger Green interview Stephen Harrison, Donna Cryer, Naim Alkhouri, Ian Rowe and Jörn Schattenberg to discuss what we have experienced during the first year of SurfingNASH. Each participant reminisces on how they came to the podcast and their favorites memories of the first year, discusses how SurfingNASH brings value to the Fatty Liver community and discussed what they hope to see from the podcast in the year ahead. Equal parts intellectual, warm and funny, this episode will show you sides of the Surfers you haven't seen on earlier episodes, reveals favorite moments and asks some important questions about where Fatty Liver diagnostics and treatment are headed.

Quentin Anstee, Louise Campbell, Stephen Harrison, Mazen Noureddin, Ian Rowe and Roger Green convene to review #ILC2021 and share key takeaways and insights. This conversation covers issues around drug development.

The conversation addressed the various ways that the challenges that the COVID-19 pandemic created for clinical trials in 2020 played out in the drug development presentations at #ILC2021: a higher level of retrospective analysis of earlier trials and relatively few pieces of novel Phase 2b or Phase 3 research adding to knowledge and insight. The group noted that cirrhosis received relatively more attention and even some fresh data as with the efruxifermin late-breaker publication. Finally, the group discussed some of the studies and insights we can expect to see between now and 2022.

Key opinion leaders Quentin Anstee, Mazen Noureddin and Ian Rowe join Stephen, Louise and Roger to discuss the major lessons and dangling questions from #ILC2021.

The group shares perspectives, insights and questions on four key topics: diagnostics (including both non-invasive technologies and AI/machine learning), drug development, patient populations and policy.Mixed in here you will find discussions on food insecurity, polygenic risk and multi-disciplinary medicine. A great session to hear if you are still organizing your takeaways and questions emerging from the Congress.

Description
Carlo Gesualdo was both a vicious murderer and brilliant composer—the two going hand in hand. Take a minute to get the scoop!

Fun Fact
There have been no fewer than eleven operatic works on the subject of Gesualdo’s life, with Alfred Schnittke (1934-1998) premiering his Gesualdo in 1993.

About Steven
Steven is a Canadian composer living in Toronto. He creates a range of works, with an emphasis on the short-form genre—his muse being to offer the listener both the darker and more satiric shades of human existence. If you're interested, please check out his website for more.

A Note To Music Students et al.
All recordings and sheet music are available on my site. I encourage you to take a look and play through some. Give me a shout if you have any questions.

Got a topic? Pop me off an email at: TCMMPodcast@Gmail.com 

Incoming EASL Secretary General Prof. Thomas Berg, Global Liver Institute President and CEO Donna Cryer and Genfit Head of Global Diagnostics Suneil Hosmane share their unique perspectives on Digital ILC 2021 with Roger Green.

In our lead-in episode for #ILC2021, Roger Green conducts interviews with three leaders, each with a unique perspective on what they value about this week's Congress. Incoming EASL Secretary General Prof. Thomas Berg discusses his view on the various ways the Congress will enrich knowledge and interaction in the global Fatty Liver community. Global Liver Institute President and CEO Donna Cryer shares the many ways that ILC has made patients and advocates feel they are welcome at the Congress and capable of making a contribution. Finally, Genfit Head of Global Diagnostics Suneil Hosmane identifies several areas of knowledge that he considers in assessing commercial opportunities. This can serve as a helpful introduction to the Congress or an opportunity to process what you have just seen and learned.

 Stephen Harrison and Jörn Schattenberg discuss what the titles of Digital ILC 2021 presentations tell us about possible findings in drug development.

Drug development presentations will occur throughout Digital ILC 2021, ranging from late-breakers to general session presentations to dedicated sessions. Stephen and Jörn use the titles of presentation to discuss areas of drug development, paying particular attention to treating cirrhosis on one end and drugs that address defatting the liver through metabolic modes of action.

 Joern Schattenberg joins the Surfers to identify exciting presentations and sessions from the Digital ILC 2021 meeting.

 Digital ILC 2021 kicks off one week from today, with four days of sessions covering the entire range of liver topics. Professor Schattenberg joins Dr. Stephen Harrison, Louise Campbell and Roger Green in identifying presentations, sessions and major themes they believe will import new knowledge and even change the ways we look at NAFLD and NASH. Want to get revved up for the Congress? Listen here.

Global Liver Institute Director of Global Policy Andrew Scott, Madrigal Pharmaceuticals Co-Founder and CMO Becky Taub, and Central Virginia VA Health Care System Chief of Hepatology and Gastroenterology Dr. Michael Fuchs discuss GLI's US NASH Action Plan and steps different stakeholders can take to support the Plan. In this conversation, the group considers systems issues ranging from commitment to multi-disciplinary approaches to including Fatty Liver metrics in metrics like HEDIS in terms of their ability to focus needed care and attention on NAFLD and NASH.

Michael Fuchs starts by discussing the value of having a multi-disciplinary mission and vision for patient treatment. From there, the group points to several different approaches -- communication, metrics, education -- that will be pivotal to driving that kind of vision and making it effective. In the end, the panelists discuss actions they each can take over the next six months to move us closer to realizing the Action Plan vision.

This conversation is sponsored with a grant from Madrigal Pharmaceuticals. Madrigal Pharmaceuticals is leading the field of NASH therapeutic development with resmetirom, a thyroid receptor beta agonist with potential to address both the liver pathophysiology and fibrosis caused by NASH.