PMID- 37020273
OWN - NLM
STAT- MEDLINE
DCOM- 20230407
LR  - 20230411
IS  - 1471-230X (Electronic)
IS  - 1471-230X (Linking)
VI  - 23
IP  - 1
DP  - 2023 Apr 5
TI  - The burden of nonalcoholic steatohepatitis (NASH) in the United States.
PG  - 109
LID - 10.1186/s12876-023-02726-2 [doi]
LID - 109
AB  - BACKGROUND: There is limited data on the comparative economic and humanistic 
      burden of non-alcoholic steatohepatitis (NASH) in the United States. The 
      objective was to examine the burden of disease comparing NASH to a representative 
      sample of the general population and separately to a type 2 diabetes mellitus 
      (T2DM) cohort by assessing health-related quality of life (HRQoL) measures, 
      healthcare resource use (HRU) and work productivity and activity impairment 
      (WPAI). METHODS: Data came from the 2016 National Health and Wellness Survey, a 
      nationally representative patient-reported outcomes survey conducted in the 
      United States. Respondents with physician-diagnosed NASH, physician-diagnosed 
      T2DM, and respondents from the general population were compared. Humanistic 
      burden was examined with mental (MCS) and physical (PCS) component summary scores 
      from the Short-Form (SF)-36v2, concomitant diagnosis of anxiety, depression, and 
      sleep difficulties. Economic burden was analysed based on healthcare professional 
      (HCP) and emergency room (ER) visits, hospitalizations in the past six months; 
      absenteeism, presenteeism, overall work impairment, and activity impairment 
      scores on WPAI questionnaire. Bivariate and multivariable analysis were conducted 
      for each outcome and matched comparative group. RESULTS: After adjusting for 
      baseline demographics and characteristics, NASH (N = 136) compared to the matched 
      general population cohort (N = 544), reported significantly lower (worse) mental 
      (MCS 43.19 vs. 46.22, p = 0.010) and physical (PCS 42.04 vs. 47.10, p < 0.001) 
      status, higher % with anxiety (37.5% vs 25.5%, p = 0.006) and depression (43.4% 
      vs 30.1%, p = 0.004), more HCP visits (8.43 vs. 5.17), ER visits (0.73 vs. 0.38), 
      and hospitalizations (0.43 vs. 0.2) all p's < 0.05, and higher WPAI scores (e.g. 
      overall work impairment 39.64% vs. 26.19%, p = 0.011). NASH cohort did not differ 
      from matched T2DM cohort (N = 272) on mental or work-related WPAI scores, but had 
      significantly worse physical status (PCS 40.52 vs. 44.58, p = 0.001), higher % 
      with anxiety (39.9% vs 27.8%, p = 0.043), more HCP visits (8.63 vs. 5.68, 
      p = 0.003) and greater activity impairment (47.14% vs. 36.07%, p = 0.010). 
      CONCLUSION: This real-world study suggests that burden of disease is higher for 
      all outcomes assessed among NASH compared to matched general controls. When 
      comparing to T2DM, NASH cohort has comparable mental and work-related impairment 
      but worse physical status, daily activities impairment and more HRU.
CI  - (c) 2023. The Author(s).
FAU - Tapper, Elliot B
AU  - Tapper EB
AD  - University of Michigan, Ann Arbor, MI, USA.
FAU - Krieger, Nancy
AU  - Krieger N
AD  - Novartis Pharmaceuticals Corp, East Hanover, NJ, USA.
FAU - Przybysz, Raymond
AU  - Przybysz R
AD  - Novartis Pharmaceuticals Corp, East Hanover, NJ, USA.
FAU - Way, Nate
AU  - Way N
AD  - Cerner Enviza, Malvern, PA, USA.
FAU - Cai, Jennifer
AU  - Cai J
AD  - Novartis Pharmaceuticals Corp, East Hanover, NJ, USA.
FAU - Zappe, Dion
AU  - Zappe D
AD  - Novartis Pharmaceuticals Corp, East Hanover, NJ, USA.
FAU - McKenna, Sarah Jane
AU  - McKenna SJ
AD  - Novartis Business Services Centre, Dublin, Ireland. 
      sarah_jane.mckenna@novartis.com.
FAU - Wall, Garth
AU  - Wall G
AD  - Novartis Pharmaceuticals Corp, East Hanover, NJ, USA.
FAU - Janssens, Nico
AU  - Janssens N
AD  - Novartis Pharma AG, Basel, Switzerland.
FAU - Balp, Maria-Magdalena
AU  - Balp MM
AD  - Novartis Pharma AG, Basel, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20230405
PL  - England
TA  - BMC Gastroenterol
JT  - BMC gastroenterology
JID - 100968547
SB  - IM
MH  - Humans
MH  - United States
MH  - Quality of Life
MH  - Cost of Illness
MH  - *Non-alcoholic Fatty Liver Disease
MH  - *Diabetes Mellitus, Type 2
MH  - Surveys and Questionnaires
MH  - Health Surveys
PMC - PMC10077759
OTO - NOTNLM
OT  - Burden of illness
OT  - NAFLD
OT  - Nonalcoholic fatty liver disease
OT  - Type 2 diabetes
OT  - US
COIS- Elliot B. Tapper received a consultancy fee for his medical expertise on this 
      project from Novartis Pharmaceuticals Corp., US. Maria-Magdalena Balp and Nico 
      Janssens are employees of Novartis Pharma AG, Basel, Switzerland. Nate Way is an 
      employee of Cerner Enviza (formally Kantar Health), Raymond Przybysz and Jennifer 
      Cai are employees of Novartis Pharmaceuticals Corp., US, and Sarah Jane McKenna 
      is an employee of Novartis Business Services Centre, Ireland. Nancy Krieger, Dion 
      Zappe and Garth Wall were employees of Novartis Pharmaceuticals Corp., US at the 
      time of the study and the initial development of the manuscript.
EDAT- 2023/04/06 06:00
MHDA- 2023/04/07 06:42
PMCR- 2023/04/05
CRDT- 2023/04/05 23:53
PHST- 2022/01/25 00:00 [received]
PHST- 2023/03/14 00:00 [accepted]
PHST- 2023/04/07 06:42 [medline]
PHST- 2023/04/05 23:53 [entrez]
PHST- 2023/04/06 06:00 [pubmed]
PHST- 2023/04/05 00:00 [pmc-release]
AID - 10.1186/s12876-023-02726-2 [pii]
AID - 2726 [pii]
AID - 10.1186/s12876-023-02726-2 [doi]
PST - epublish
SO  - BMC Gastroenterol. 2023 Apr 5;23(1):109. doi: 10.1186/s12876-023-02726-2.