Commentary
Although early stages of NASH may not be associated with severe symptoms, it is increasingly appreciated that NASH is not an asymptomatic disease. In fact, systematic assessments of patients with NASH using validated health-related quality- of-life instruments suggest significant impairment of patient-reported outcomes. Fatigue and pruritus are common in patients with chronic liver diseases of all aetiologies, but clinical awareness is mostly restricted to those with cholestatic liver diseases.
ZM Younossi et al. (Betty and Guy Beatty Center for Integrated Research, Inova Health System, and Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, Virginia, USA) assessed the impact of fatigue and pruritus on patient-reported outcomes of patients with advanced NASH. Among the included 1,669 patients with advanced NASH, 33% and 27% had fatigue and pruritus, respectively. All patient-reported outcomes were impaired by up to −19% in patients with NASH with pruritus.
