Liver and Bile

J Hepatol. 2024;80(3):409–18

Díaz LA, Fuentes-López E, Idalsoaga F, Ayares G, Corsi O, Arnold J, Cannistra M, Vio D, Márquez-Lomas A, Ramirez-Cadiz C, Medel MP, Hernandez-Tejero M, Ferreccio C, Lazo M, Roblero JP, Cotter TG, Kulkarni AV, Kim W, Brahmania M, Louvet A, Tapper EB, Dunn W, Simonetto D, Shah VH, Kamath PS, Lazarus JV, Singal AK, Bataller R, Arrese M, Arab JP

Association between public health policies on alcohol and worldwide cancer, liver disease and cardiovascular disease outcomes

Background and aims: The long-term impact of alcohol-related public health policies (PHPs) on disease burden is unclear. The authors aimed to assess the association between alcohol-related PHPs and alcohol-related health consequences.
Methods: They conducted an ecological multinational study including 169 countries, and collected data on alcohol-related PHPs from the WHO Global Information System of Alcohol and Health 2010. Data on alcohol-related health consequences between 2010 and 2019 were obtained from the Global Burden of Disease database. PHPs were classified into 5 items, including criteria for low, moderate, and strong PHP establishment. The authors estimated an alcohol preparedness index (API) using multiple correspondence analysis (0 lowest and 100 highest establishment). They also estimated an incidence rate ratio (IRR) for outcomes according to API using adjusted multilevel generalized linear models with a Poisson family distribution.
Results: The median API in the 169 countries was 54 (interquartile range, 34.9–76.8). The API was inversely associated with alcohol use disorder (AUD) prevalence (IRR = 0.13; 95% confidence interval [CI]: 0.03–0.60; p = 0.010), alcohol-associated liver disease (ALD) mortality (IRR = 0.14; 95% CI: 0.03–0.79; p = 0.025), mortality due to neoplasms (IRR = 0.09; 95% CI: 0.02–0.40; p = 0.002), alcohol-attributable hepatocellular carcinoma (HCC) (IRR = 0.13; 95% CI: 0.02–0.65; p = 0.014), and cardiovascular diseases (IRR = 0.09; 95% CI: 0.02–0.41; p = 0.002). The highest associations were observed in the Americas, Africa, and Europe. These associations became stronger over time, and AUD prevalence was significantly lower after 2 years, while ALD mortality and alcohol-attributable HCC incidence decreased after 4 and 8 years from baseline API assessment, respectively (p < 0.05).

Conclusions: The alcohol preparedness index (API) is a valuable instrument to quantify the robustness of alcohol-related public health policy (PHP) establishment. Lower alcohol use disorder prevalence and lower mortality related to alcohol-associated liver disease, neoplasms, alcohol-attributable hepatocellular carcinoma, and cardiovascular diseases were observed in countries with a higher API. These results encourage the development and strengthening of alcohol-related policies worldwide.

Prof. Dr. J.P. Arab, Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University, London, ON, Canada, E-Mail: juan.arab@uwo.ca

DOI: 10.1016/j.jhep.2023.11.006

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Liver and Bile

Adequate versus deep response to ursodeoxycholic acid in primary biliary cholangitis: To what extent and under what conditions is normal alkaline phosphatase level associated with complication-free survival gain?

Hepatology. 2024;79(1):39–48

Corpechot C, Lemoinne S, Soret PA, Hansen B, Hirschfield G, Gulamhusein A, Montano-Loza AJ, Lytvyak E, Pares A, Olivas I, Eaton JE, Osman KT, Schramm C, Sebode M, Lohse AW, Dalekos G, Gatselis N, Nevens F, Cazzagon N, Zago A, Russo FP, Floreani A, Abbas N, Trivedi P, Thorburn D, Saffioti F, Barkai L, Roccarina D, Calvaruso V, Fichera A, Delamarre A, Sobenko N, Villamil AM, Medina-Morales E, Bonder A, Patwardhan V, Rigamonti C, Carbone M, Invernizzi P, Cristoferi L, van der Meer A, de Veer R, Zigmond E, Yehezkel E, Kremer AE, Deibel A, Bruns T, Große K, Wetten A, Dyson JK, Jones D, Dumortier J, Pageaux GP, de Lédinghen V, Chazouillères O, Carrat F; Global & ERN Rare-Liver PBC Study Groups

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Liver and Bile

A phase 3, randomized, controlled trial of resmetirom in NASH with liver fibrosis

N Engl J Med. 2024;390(6):497–509