Editor's note: Recently, the Combined GlHep&SHC 2024 was successfully held in Singapore. This conference covers various aspects of liver disease research and provides an interdisciplinary communication platform for experts and scholars. During the conference, Hepatology Digest invited Dr. Yew Kuo Chao, a senior consultant at Tan Tock Seng Hospital, Singapore, to discuss topics related to metabolic associated fatty liver disease (MASLD).Hepatology Digest: What significant implications do you think this conference has in enhancing liver disease research and treatment levels in the Asia-Pacific region and even globally? What have you gained from this conference?
Dr.Yew Kuo Chao: I think this conference has actually provided us with a lot of updates in the Asia-Pacific region, as well as new advancements from a global perspective. Looking at the landscape, the diseases chosen as a focus include MASLD, the new nomenclature for what was previously called fatty liver disease, and the current efforts toward a Hepatitis B cure. To aim for a cure, there was a challenge, and there was an update in terms of guidelines from the WHO. China has also loosened its treatment criteria, with evidence showing long-term benefits, especially in reducing liver cancer.
We also had a lot of interesting data presented by local regional hospitals in terms of abstracts and oral presentations, which were fascinating to look at regarding innovation and new perspectives, especially from the South Asia region.
Hepatology Digest: Regarding the progression of MASLD to MASH and potentially further to hepatocellular carcinoma, what effective intervention methods do you think are currently available?
Dr.Yew Kuo Chao: This is quite a challenging question to answer at this stage of development. What we understand now is that it is actually under the metabolic syndrome umbrella. At the moment, there are a lot of pharmacological combinations targeting multiple aspects to provide total efficacy in outcomes like cardiovascular, renal, HCC (hepatocellular carcinoma), and liver fibrosis. There’s also some insight into the cirrhosis stage, which is more difficult to treat and reverse. There has been mention of the capillarisation and angiogenesis of the disease, which may be a new target for this MASH cirrhosis group of patients.
Personally, I think we’re moving towards a personalized approach. Not one single intervention will fit all patients. We have to integrate genetics, epigenetics, and lifestyle interventions to restratify the patient, allowing them to choose the appropriate management. It’s very interesting, and in terms of histology and fibrosis improvement, there’s been an advancement achieving about 50-60% fibrosis reversal. This is a remarkable step forward in medical advancement for us.
