The PanNASH slide kit: educational material for healthcare professionals interested in NASH

1. Tsochatzis EA et al. Lancet Gastroenterol Hepatol 2018;3:509-17;

2. Singh S et al. Clin Gastroenterol Hepatol 2015;13:643-54.e1-9; quiz e39-40

The slide above illustrates an important point: the progression of liver damage in the context of NAFLD or NASH is not fully understood, mainly due to the reliance on liver biopsy to track changes in liver injury. Moreover, most of the datasets that have been reported were from single centre studies from specialist units, where repeat biopsies occurred in response to clinical events. This inevitably results in bias, because repeat biopsies are driven by clinical concerns in many patients, providing a non-representative understanding of the overall rate of disease progression. Singh and colleagues analysed the rate of histological fibrosis progression (to higher stages of disease) in adults with NAFLD and found that the rate differed depending on the severity of baseline disease. In patients with more indolent disease at the outset, progress appeared to be slower, whereas in patients with NASH at baseline, fibrosis progressed more rapidly. These data are helpful to inform the field, but it should be noted that all rates of progression were still slow. The time taken to advance by one stage of liver fibrosis was 7 years in fast progressing disease (NASH) versus 14 years in slow progressing disease (NAFLD).

Do you want to learn more about définitions and epidemiology ? Download the first 75 slides of the PanNASH slide kit below.



All slides are the property of the Pannash group and and their content should not be altered on reproduction. This information is for healthcare professionals only and intended for educational purposes.

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  1. Tsochatzis EA, Newsome PN. Non-alcoholic fatty liver disease and the interface between primary and secondary care. Lancet Gastroenterol Hepatol 2018; 3(7): 509-17.
  2. 1. Singh S, Allen AM, Wang Z, Prokop LJ, Murad MH, Loomba R. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol 2015; 13(4): 643-54.e1-9; quiz e39-40.