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Liver Fat – Deadly if Not Treated

Liver disease is on the rise among middle-aged Americans.  The Centers for Disease Control and Prevention (CDC) reports that fatty liver disease, viral hepatitis, and alcoholic liver disease are the major contributors to a rise in liver-disease-related deaths and liver cancer in people ages 45-64.   Teen-idol David Cassidy died in 2017 of alcohol-related liver disease and his death is just one example of the risks of liver disease in his particular age group.

Until recently hepatitis C was the most common reason for liver transplant.  Now that effective medications are available to treat Hepatitis C, James Trotter, MD, Medical Director of Liver Transplantation at Baylor University Medical Center Dallas says fatty liver disease has replaced Hepatitis C as the most common reason for a new listing for liver transplant. 

"The most progressive form of fatty liver disease is NASH, nonalcoholic steatohepatitis.  A patient with NASH typically has liver inflammation, leading to cirrhosis, liver failure and liver cancer.   By 2020, NASH will be the leading reason for liver transplant."

Obesity-related liver disease affects up to 25% of Americans, according to the American Liver Foundation.  Despite the risks and rise in fatty liver disease, no medical treatment is available.  However, medical research is underway.  Dr. Trotter is a primary investigator on a research study examining how safe and effective the drug Obeticholic Acid (OCA) may be in delaying or preventing specific medical conditions or health-related problems occurring in patients with NASH and evidence of liver fibrosis.  The Dallas area research study has more participants than any other study site in the U.S with 40 patients already enrolled. 

"We have a lot of overweight people in this area of Texas and despite their efforts at conventional weight loss; their liver disease is getting worse.  70% of the current study enrollees are overweight," Trotter says. 

To enroll in the study, eligible NASH patients must

  • Be 18 years or over
  • Been diagnosed with NASH with Fibrosis by liver biopsy

Approved study subjects will receive the investigational drug OCA or placebo.  Treatment is assigned randomly.  Neither patient nor doctor knows what study treatment has been assigned.  Patients will participate for up to 6 years with routine evaluation. 

Dr. Trotter says, "There are a number of clinical trials available for patients with NASH and they are important for patients to consider since there is no known therapy for this increasingly common problem. While some patients will get placebo in the clinical trials, every patient outside of a clinical trial is effectively on "placebo," because of the absence of a known treatment."

In the meantime, the only other known treatment for alleviating or reversing the damage done by fatty liver disease is to lose weight. 

For more information on the research study check out

There are several other studies currently enrolling at the clinic. This includes non-invasive markers to predict the presence of fatty liver (Sumeet Asrani MD MSc), new medications to combat fatty liver (Saleh Elwir MD) and to treat portal hypertension (Robert Rahimi MD).