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1. Sex and Race-Ethnic Disparities in Metabolic Dysfunction-Associated Steatotic Liver Disease: An Analysis of 40,166 Individuals

Author

Fu, Clarissa Elysia, Teng, Margaret, Tung, Daniel, Ramadoss, Vijay, Ong, Christen, Koh, Benjamin, Lim, Wen Hui, Tan, Darren Jun Hao, Koh, Jia Hong, Nah, Benjamin, Syn, Nicholas, Tamaki, Nobuharu, Siddiqui, Mohammad Shadab, Wijarnpreecha, Karn, Ioannou, George N., Nakajima, Atsushi, Noureddin, Mazen, Sanyal, Arun J., Ng, Cheng Han, and Muthiah, Mark

Published
2024
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2. Meta‐analysis: Prevalence and impact of alcohol abstinence in alcohol‐associated cirrhosis

Author

Lim, Wen Hui, Tay, Phoebe, Ng, Cheng Han, Tan, Darren Jun Hao, Ong, Christen, Koh, Jia Hong, Teng, Margaret, Chee, Douglas, Wong, Zhen Yu, Kawaguchi, Takumi, Takahashi, Hirokazu, Muthiah, Mark, Tan, Eunice XX, Wijarnpreecha, Karn, Lee, Guan Huei, Noureddin, Mazen, Lee, Brian P, Mathurin, Philippe, Loomba, Rohit, and Huang, Daniel Q

Subjects
Pharmacology and Pharmaceutical Sciences, Biomedical and Clinical Sciences, Clinical Sciences, Substance Misuse, Alcoholism, Alcohol Use and Health, Clinical Research, Prevention, Cancer, Oral and gastrointestinal, Cardiovascular, Good Health and Well Being, Humans, Prospective Studies, Retrospective Studies, Prevalence, Alcohol Abstinence, Liver Cirrhosis, Alcoholic, abstinence, cirrhosis, hepatocellular carcinoma, prevalence, survival, Gastroenterology & Hepatology, Clinical sciences, Pharmacology and pharmaceutical sciences
Abstract

BackgroundAlthough alcohol abstinence may be an effective intervention for alcohol-associated cirrhosis, its association with prognosis has not been systematically assessed or quantified.AimsTo determine the prevalence of alcohol abstinence, factors associated with alcohol abstinence and the impact of abstinence on morbidity and overall survival in people with alcohol-associated cirrhosis.MethodsWe searched Medline and Embase from inception to 15 April 2023 for prospective and retrospective cohort studies describing alcohol abstinence in people with known alcohol-associated cirrhosis. Meta-analysis of proportions for pooled estimates was performed. The method of inverse variance, employing a random-effects model, was used to pool the hazard ratio (HR) comparing outcomes of abstinent against non-abstinent individuals with alcohol-associated cirrhosis.ResultsWe included 19 studies involving 18,833 people with alcohol-associated cirrhosis. The prevalence of alcohol abstinence was 53.8% (CI: 44.6%-62.7%). Over a mean follow-up duration of 48.6 months, individuals who continued to consume alcohol had significantly lower overall survival compared to those who were abstinent (HR: 0.611, 95% CI: 0.506-0.738). These findings remained consistent in sensitivity/subgroup analysis for the presence of decompensation, study design and studies that assessed abstinence throughout follow-up. Alcohol abstinence was associated with a significantly lower risk of hepatic decompensation (HR: 0.612, 95% CI: 0.473-0.792).ConclusionsAlcohol abstinence is associated with substantial improvement in overall survival in alcohol-associated cirrhosis. However, only half of the individuals with known alcohol-associated cirrhosis are abstinent.

Published
2024

3. Sex-based Disparities in Liver Transplantation for Hepatocellular Carcinoma and the Impact of the Growing Burden of NASH

Author

Koh, Jia Hong, Chee, Douglas, Ng, Cheng Han, Wijarnpreecha, Karn, Muthiah, Mark, Tan, Darren Jun Hao, Lim, Wen Hui, Zeng, Rebecca Wenling, Koh, Benjamin, Xuan, Eunice Tan Xiang, Bonney, Glenn, Iyer, Shridhar, Young, Dan Yock, Nakamura, Toru, Takahashi, Hirokazu, Noureddin, Mazen, Siddiqui, Mohammad Shadab, Simon, Tracey G, Loomba, Rohit, and Huang, Daniel Q

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Women's Health, Rare Diseases, Organ Transplantation, Digestive Diseases, Cancer, Chronic Liver Disease and Cirrhosis, Liver Cancer, Clinical Research, Hepatitis, Transplantation, Liver Disease, Oral and gastrointestinal, Good Health and Well Being, Cardiovascular medicine and haematology, Clinical sciences, Immunology
Abstract

BackgroundThe cause of liver disease is changing, but its impact on liver transplantation (LT) for hepatocellular carcinoma (HCC) in women and men is unclear. We performed a nationwide study to assess the prevalence and posttransplant survival outcomes of the various causes of liver disease in women and men with HCC.MethodsData were obtained from the United Network for Organ Sharing database from 2000 to 2022. Data related to the listing, transplant, waitlist mortality, and posttransplant mortality for HCC were extracted. The proportion of HCC related to the various causes of liver disease among LT candidates and recipients and posttransplant survival were compared between women and men.ResultsA total of 51 721 individuals (39 465 men, 12 256 women) with HCC were included. From 2000 to 2022, nonalcoholic steatohepatitis (NASH) was the fastest-growing cause of liver disease among female LT candidates with HCC (P

Published
2024

4. Patterns in Cancer Incidence Among People Younger Than 50 Years in the US, 2010 to 2019

Author

Koh, Benjamin, Tan, Darren Jun Hao, Ng, Cheng Han, Fu, Clarissa Elysia, Lim, Wen Hui, Zeng, Rebecca Wenling, Yong, Jie Ning, Koh, Jia Hong, Syn, Nicholas, Meng, Wang, Wijarnpreecha, Karn, Liu, Ken, Chong, Choon Seng, Muthiah, Mark, Luu, Hung N, Vogel, Arndt, Singh, Siddharth, Yeoh, Khay Guan, Loomba, Rohit, and Huang, Daniel Q

Subjects
Health Services and Systems, Biomedical and Clinical Sciences, Health Sciences, Breast Cancer, Clinical Research, Cancer, Digestive Diseases, Humans, Male, Female, Middle Aged, Aged, Incidence, Cohort Studies, Breast Neoplasms, Ethnicity, Registries, Biomedical and clinical sciences, Health sciences
Abstract

ImportanceEmerging data suggest that the incidence of early-onset cancers, defined as cancers diagnosed in people younger than 50 years, is increasing, but updated data are limited.ObjectiveTo characterize the patterns in the incidence of early-onset cancers in the US from 2010 to 2019 and provide granular data on the cancers with the fastest-growing incidence rates.Design, setting, and participantsThis population-based cohort study analyzed data from 17 National Cancer Institute Surveillance, Epidemiology, and End Results registries from January 1, 2010, to December 31, 2019. Age-standardized incidence rates per 100 000 people were extracted for early-onset cancers, with rates age adjusted to the US standard population. A total of 562 145 patients with early-onset cancer between 2010 and 2019 were identified and included. Data were analyzed from October 16, 2022, to May 23, 2023.Main outcomes and measuresPrimary outcomes were incidence rates and descriptive epidemiological data for people younger than 50 years with cancer. The annual percentage change (APC) of the age-standardized incidence rate was estimated using the Joinpoint regression program.ResultsAmong 562 145 patients (324 138 [57.7%] aged 40-49 years; 351 120 [62.5%] female) with early-onset cancer, 4565 (0.8%) were American Indian or Alaska Native, 54 876 (9.8%) were Asian or Pacific Islander, 61 048 (10.9%) were Black, 118 099 (21.0%) were Hispanic, 314 610 (56.0%) were White, and 8947 (1.6%) were of unknown race and/or ethnicity. From 2010 to 2019, the age-standardized incidence rate of early-onset cancers increased overall (APC, 0.28%; 95% CI, 0.09%-0.47%; P = .01) and in female individuals (APC, 0.67%; 95% CI, 0.39%-0.94%; P = .001) but decreased in male individuals (APC, -0.37%; 95% CI, -0.51% to -0.22%; P

Published
2023

5. IDDF2023-ABS-0012 Gastrointestinal cancers are the leading cause of young onset cancer in the United States

Author

Koh, Benjamin, Tan, Darren Jun-Hao, Ng, Cheng-Han, Lim, Wen-Hui, Zeng, Rebecca Wenling, Fu, Clarissa Elysia, Xiao, Jieling, Koh, Jia-Hong, Nah, Benjamin, Syn, Nicholas, Teng, Margaret, Liu, Ken, Nobuharu, Tamaki, Muthiah, Mark, Seng, Chong-choon, Chen, Vincent L, Yeoh, Khay Guan, and Loomba, Rohit

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Clinical Sciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics
Published
2023

6. Hepatocellular Carcinoma Incidence in Alcohol-Associated Cirrhosis: Systematic Review and Meta-analysis

Author

Huang, Daniel Q, Tan, Darren JH, Ng, Cheng Han, Amangurbanova, Maral, Sutter, Nancy, Lin Tay, Phoebe Wen, Lim, Wen Hui, Yong, Jie Ning, Tang, Ansel, Syn, Nicholas, Muthiah, Mark D, Tan, Eunice XX, Dave, Shravan, Tay, Benjamin, Majzoub, Abdul M, Gerberi, Danielle, Kim, Beom Kyung, and Loomba, Rohit

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Liver Disease, Clinical Trials and Supportive Activities, Hepatitis, Clinical Research, Digestive Diseases, Alcoholism, Alcohol Use and Health, Chronic Liver Disease and Cirrhosis, Cancer, Liver Cancer, Rare Diseases, Substance Misuse, Prevention, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Good Health and Well Being, Humans, Carcinoma, Hepatocellular, Incidence, Liver Neoplasms, Prospective Studies, Esophageal and Gastric Varices, Gastrointestinal Hemorrhage, Liver Cirrhosis, Alcoholic, Liver Cirrhosis, Risk Factors, Alcohol, Cirrhosis, Hepatocellular Carcinoma, Gastroenterology & Hepatology, Clinical sciences
Abstract

Background & aimsAlcohol is one of the leading causes of hepatocellular carcinoma (HCC). However, pooled estimates of HCC incidence in alcohol-associated cirrhosis have not been evaluated systematically. We performed a pooled analysis of time-to-event data to provide robust estimates for the incidence of HCC in alcohol-associated cirrhosis.MethodsMedline, Embase, Cochrane Central Register, Scopus, and Web of Science were searched from inception to August 2021. Individual patient data were reconstructed from published Kaplan-Meier curves, and a pooled analysis of cumulative HCC incidence was performed using a random-effects model.ResultsWe screened 5022 articles and included 18 studies (148,333 patients). In the pooled analysis, the cumulative incidence of HCC in alcohol-associated cirrhosis at 1, 5, and 10 years among studies that accounted for the competing risk of death without HCC was 1%, 3%, and 9%, respectively. A secondary analysis by traditional meta-analysis determined that the HCC incidence rate was higher in cohorts enrolled in a HCC surveillance program (18.6 vs 4.8 per 1000 person-years; P = .001) vs those who were not enrolled in a surveillance program. Meta-regression showed that diabetes, smoking, variceal bleeding, and hepatic decompensation were associated with a higher risk of HCC.ConclusionsOur analysis determined that the 5- and 10- year cumulative risk of HCC in alcohol-associated cirrhosis was 3% and 9%, respectively, with a higher incidence in cohorts that were enrolled in a HCC surveillance program. These data should be validated further in large prospective studies, and may have important implications for HCC screening and surveillance among patients with alcohol-associated cirrhosis.

Published
2023

7. 919 GLOBAL EPIDEMIOLOGY OF CIRRHOSIS: CHANGING ETIOLOGICAL BASIS AND DISEASE BURDEN BETWEEN FEMALES AND MALES

Author

Zeng, Rebecca Wenling, Xiao, Jieling, Fu, Clarissa E, Tan, Darren J, Chan, Kai En, Ng, Cheng Han, Lim, Wen Hui, Muthiah, Mark, Koh, Benjamin, Tan, Eunice X, Teng, Margaret LP, Dan, Yock Young, Siddiqui, Mohammad Shadab, Loomba, Rohit, and Huang, Daniel

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Nutrition and Dietetics, Neurosciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics
Published
2023

8. 400 QUALITY ASSESSMENT OF LIVER VISUALISATION THROUGH IMAGING FOR DETECTION AND SURVEILLANCE OF HEPATOCELLULAR CARCINOMA: SYSTEMATIC REVIEW AND META-ANALYSIS

Author

Quek, Jingxuan, Xiao, Jieling, Fu, Clarissa E, Tan, Darren J, Chan, Kai En, Lim, Wen Hui, Ng, Cheng Han, Syn, Nicholas L, Teng, Margaret LP, Muthiah, Mark, Loomba, Rohit, and Huang, Daniel

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Good Health and Well Being, Neurosciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics
Published
2023

9. Placebo Adverse Events in Non-alcoholic Steatohepatitis Clinical Trials: A Pooled Analysis of 2,944 Participants

Author

Tay, Phoebe Wen Lin, Ng, Cheng Han, Lin, Snow Yunni, Chin, Yip Han, Xiao, Jieling, Lim, Wen Hui, Lim, Sze Yinn, Fu, Clarissa Elysia, Chan, Kai En, Quek, Jingxuan, Tan, Darren Jun Hao, Chew, Nicholas, Syn, Nicholas, Keitoku, Taisei, Tamaki, Nobuharu, Siddiqui, Mohammad Shadab, Noureddin, Mazen, Muthiah, Mark, Huang, Daniel Q, and Loomba, Rohit

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Hepatitis, Clinical Research, Digestive Diseases, Clinical Trials and Supportive Activities, Liver Disease, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Humans, Non-alcoholic Fatty Liver Disease, Bile Acids and Salts, Randomized Controlled Trials as Topic, Gastroenterology & Hepatology, Clinical sciences
Abstract

IntroductionIn the absence of an effective treatment for non-alcoholic steatohepatitis (NASH), a randomized, placebo-controlled trial (RCT) remains the current gold standard study design in NASH. As NASH is a largely asymptomatic disease, the side effects of potential therapies require careful evaluation, therefore a pooled rate of the adverse events (AEs) in placebo-treated patients serves as a useful comparator for safety. Therefore, we performed a systematic review and meta-analysis to estimate the rate of AEs among participants in the placebo arm of NASH RCTs.MethodsMedline, Embase and Cochrane Central Register of Controlled Trials were searched to include clinical trials in phase 2-4 NASH RCTs with placebo treatment arms. A pooled proportions of AEs were analyzed using a generalized linear mixed model with Clopper-Pearson intervals.ResultsA total of 41 RCTs (2,944 participants on placebo) were included in this meta-analysis. A total of 68% (confidence interval [CI] 55%-77%) of participants on placebo experienced an AE, 7.8% (5.7%-10%) experienced serious AEs and 3.1% (CI: 1.9%-5.1%) experienced AEs leading to discontinuation. A significantly higher proportion of participants experienced serious AEs in phase 3 studies compared to in phase 2 studies ( P < 0.01) and in pharmaceutical funded studies as compared to studies which were federal-funded studies ( P < 0.01). An analysis of clinical trials evaluating bile acid modulating agents determined that 10% (CI: 5.5%-18%) of participants receiving placebo developed pruritus.DiscussionThe present study summarizes the AEs with NASH placebo. Among participants in the placebo arm in NASH, two-third experienced an AE, and nearly 10% experienced a serious AE.

Published
2023

10. Mortality Outcomes by Fibrosis Stage in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis

Author

Ng, Cheng Han, Lim, Wen Hui, Hui Lim, Grace En, Hao Tan, Darren Jun, Syn, Nicholas, Muthiah, Mark D, Huang, Daniel Q, and Loomba, Rohit

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Liver Disease, Digestive Diseases, Clinical Research, Clinical Trials and Supportive Activities, Chronic Liver Disease and Cirrhosis, Oral and gastrointestinal, Good Health and Well Being, Humans, Non-alcoholic Fatty Liver Disease, Fibrosis, Cohort Studies, Biopsy, Liver Cirrhosis, Disease Progression, Mortality, Gastroenterology & Hepatology, Clinical sciences
Abstract

Background & aimsFibrosis is a key determinant of clinical outcomes in nonalcoholic fatty liver disease (NAFLD), but time-dependent risk of mortality has not been reported in previous meta-analyses. We performed an updated time-to-event meta-analysis to provide robust estimates for all-cause and liver-related mortality in biopsy-confirmed NAFLD with comparisons between fibrosis stages.MethodsMedline and Embase databases were searched to include cohort studies reporting survival outcomes by fibrosis stage in biopsy-proven NAFLD. Survival estimates were pooled using reconstructed individual participant data. Conventional meta-analysis was conducted to pool adjusted hazard ratios (HRs) using DerSimonian and Laird random effects model.ResultsA total of 14 articles involving 17,301 patients with NAFLD were included. All-cause mortality at 1, 5, and 10 years for stage 0 to 2 fibrosis was 0.1%, 3.3%, and 7.7% vs 0.3%, 20.6%, and 41.5% for stage 4 fibrosis. Compared with stage 0 fibrosis, all-cause mortality increased with fibrosis stage: stage 2; HR, 1.46 (95% confidence interval [CI], 1.08-1.98), stage 3; HR, 1.96 (95% CI, 1.41-2.72), and stage 4; HR, 3.66 (95% CI, 2.65-5.05). Risk for liver-related mortality increased exponentially as fibrosis stage increased: stage 2; HR, 4.07 (95% CI, 1.44-11.5), stage 3; HR, 7.59 (95% CI, 2.80-20.5), and stage 4; HR, 15.1 (95% CI, 5.27-43.4). Stage 3 to 4 fibrosis had a higher all-cause (HR, 3.32) and liver-related mortality (HR, 10.40) compared with stage 0 to 2 fibrosis, whereas stage 4 fibrosis had higher all-cause (HR, 2.67; 95% CI, 1.47-4.83) and liver-related mortality (HR, 2.57; 95% CI, 1.22-5.42) vs stage 3 fibrosis.ConclusionsRisk of all-cause and liver-related mortality increases substantially with fibrosis stage. These data have important implications for prognostication and trial design.

Published
2023

11. Meta‐analysis: Chemoprevention of hepatocellular carcinoma with statins, aspirin and metformin

Author

Zeng, Rebecca W, Yong, Jie Ning, Tan, Darren JH, Fu, Clarissa E, Lim, Wen Hui, Xiao, Jieling, Chan, Kai En, Tan, Caitlyn, Goh, Xin Lei, Chee, Douglas, Syn, Nicholas, Tan, Eunice X, Muthiah, Mark D, Ng, Cheng Han, Tamaki, Nobuharu, Lee, Sung Won, Kim, Beom Kyung, Nguyen, Mindie H, Loomba, Rohit, and Huang, Daniel Q

Subjects
Pharmacology and Pharmaceutical Sciences, Biomedical and Clinical Sciences, Clinical Sciences, Digestive Diseases, Liver Cancer, Prevention, Liver Disease, Chronic Liver Disease and Cirrhosis, Patient Safety, Rare Diseases, Cancer, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Good Health and Well Being, Humans, Carcinoma, Hepatocellular, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Liver Neoplasms, Aspirin, Metformin, Chemoprevention, hepatoma, incidence, liver cancer, prevention, Gastroenterology & Hepatology, Clinical sciences, Pharmacology and pharmaceutical sciences
Abstract

BackgroundEmerging data suggest that statins, aspirin and metformin may protect against hepatocellular carcinoma (HCC) development. However, prior meta-analyses were limited by heterogeneity and inclusion of studies without adequate adjustment for baseline risks.AimTo examine by an updated meta-analysis the association between these medications and HCC risk.MethodsMedline and Embase databases were searched from inception to March 2022 for studies that balanced baseline risks between study groups via propensity score matching or inverse probability of treatment weighting, that reported the impact of statins, aspirin or metformin on HCC risk. Multivariable-adjusted hazard ratios (HRs) for HCC were pooled using a random effects model.ResultsStatin use was associated with reduced HCC risk overall (HR: 0.52; 95% CI: 0.37-0.72) (10 studies, 1,774,476), and in subgroup analyses for cirrhosis, hepatitis B/C, non-alcoholic fatty liver disease, studies accounting for concurrent aspirin and metformin consumption and lipophilic statins. Aspirin use was associated with reduced HCC risk overall (HR: 0.48; 95% CI: 0.27-0.87) (11 studies, 2,190,285 patients) but not in studies accounting for concurrent statin and metformin use. Metformin use was not associated with reduced HCC risk overall (HR: 0.57; 95% CI: 0.31-1.06) (3 studies, 125,458 patients). Most analyses had moderate/substantial heterogeneity, except in follow-up

Published
2023

12. Proton Pump Inhibitors Increases Longitudinal Risk of Mortality, Decompensation, and Infection in Cirrhosis: A Meta-Analysis

Author

Wong, Zhen Yu, Koh, Jia Hong, Muthiah, Mark, Koh, Benjamin, Ong, Elden Yen Hng, Ong, Christen En Ya, Ou, Kai Qi, Lim, Wen Hui, Tan, Darren Jun Hao, Chee, Douglas, Siah, Kewin Tien Ho, Wong, Yujun, Kaewdech, Apichat, Wijarnpreecha, Karn, Kulkarni, Anand V., Nah, Benjamin, Huang, Daniel Q., Noureddin, Mazen, Ng, Cheng Han, and Teng, Margaret

Published
2024
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13. Survival Trends in Sorafenib for Advanced Hepatocellular Carcinoma: A Reconstructed Individual Patient Data Meta-Analysis of Randomized Trials

Author

Tan, Darren Jun Hao, Tang, Ansel Shao Pin, Lim, Wen Hui, Ng, Cheng Han, Nah, Benjamin, Fu, Clarissa, Xiao, Jieling, Koh, Benjamin, Tay, Phoebe Wen Lin, Tan, Eunice X, Teng, Margaret, Syn, Nicholas, Muthiah, Mark D, Tamaki, Nobuharu, Lee, Sung Won, Kim, Beom Kyung, Yau, Thomas, Vogel, Arndt, Loomba, Rohit, and Huang, Daniel Q

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Digestive Diseases, Clinical Trials and Supportive Activities, Cancer, Liver Cancer, Liver Disease, Hepatitis, Rare Diseases, Clinical Research, 6.1 Pharmaceuticals, Good Health and Well Being, Survival outcomes for sorafenib in advanced, improved over time, These data, important implications for clinical trial design, Hepatocellular carcinoma, Liver cancer, Systemic therapy
Abstract

BackgroundEmerging data suggest that outcomes for advanced hepatocellular carcinoma (HCC) treated with sorafenib may have improved over time. We aimed to provide robust, time-to-event estimates of survival outcomes for sorafenib in advanced HCC.SummaryIn this systematic review and individual patient data meta-analysis of randomized-controlled trials (RCTs), we searched MEDLINE and Embase from inception till September 2022 for RCTs that provided data for overall survival (OS) and progression-free survival (PFS) for sorafenib monotherapy as first-line systemic therapy for advanced HCC. We performed a pooled analysis using reconstructed individual participant data from published Kaplan-Meier curves to obtain robust estimates for OS and PFS. Of 1,599 articles identified, 29 studies (5,525 patients) met the inclusion criteria. Overall, the median OS was 10.4 (95% CI: 9.6-11.4) months. Median OS increased over time, from 9.8 (95% CI: 8.8-10.7) months in studies before 2015 to 13.4 (95% CI: 11.03-15.24) months in studies from 2015 onwards (p < 0.001). OS did not differ by trial phase, geographical region, or study design. The overall median PFS was 4.4 (95% CI: 3.9-4.8) months, but PFS did not improve over time. Sensitivity analysis of studies from 2015 and onwards to account for the introduction of direct-acting antivirals determined that hepatitis C virus was associated with reduced mortality (p < 0.001). There was minimal heterogeneity in the estimates for OS (all I2 ≤ 33).Key messagesSurvival outcomes for sorafenib in advanced HCC have improved over time. These data have important implications for clinical trial design.

Published
2023

14. Metabolic Syndrome and Metabolic Dysfunction-Associated Steatotic Liver Disease in Premenopausal Women: Global Trends and Projections to 2040

Author

Danpanichkul, Pojsakorn, Ng, Cheng Han, Muthiah, Mark D., Duangsonk, Kwanjit, Kongarin, Siwanart, Srisurapanont, Karan, Pingwang, Phakkamon, Songmueang, Nonlawan, Nonthasoot, Chalida, Manosroi, Worapaka, Nathisuwan, Surakit, Li, Fang, Yang, Ju Dong, Chen, Vincent L., Kim, Donghee, Noureddin, Mazen, Huang, Daniel Q., and Wijarnpreecha, Karn

Published
2024
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15. Disparities in metabolic dysfunction-associated steatotic liver disease and cardiometabolic conditions in low and lower middle-income countries: a systematic analysis from the global burden of disease study 2019

Author

Danpanichkul, Pojsakorn, Suparan, Kanokphong, Dutta, Priyata, Kaeosri, Chuthathip, Sukphutanan, Banthoon, Pang, Yanfang, Kulthamrongsri, Narathorn, Jaisa-aad, Methasit, Ng, Cheng Han, Teng, Margaret, Nakano, Masahito, Morishita, Asahiro, Alkhouri, Naim, Yang, Ju Dong, Chen, Vincent L., Kim, Donghee, Fallon, Michael B., Diaz, Luis Antonio, Arab, Juan Pablo, Mantzoros, Christos S., Noureddin, Mazen, Lazarus, Jeffrey V., and Wijarnpreecha, Karn

Published
2024
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16. The Global Burden of Alcohol-associated Cirrhosis and Cancer in Young and Middle-aged Adults

Author

Nah, Benjamin, Koh, Jia Hong, Teng, Margaret, Lim, Wen Hui, Ramadoss, Vijay, Thong, Elizabeth, Muthiah, Mark, Wong, Zhen Yu, Kaewdech, Apichat, Duangsonk, Kwanjit, Liu, Ken, Sano, Tomoya, Takahashi, Hirokazu, Chen, Vincent, Lee, Brian P., Danpanichkul, Pojsakorn, Ng, Cheng Han, Tan, Darren Jun Hao, Wijarnpreecha, Karn, Huang, Daniel Q., and Noureddin, Mazen

Published
2024
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18. Efficacy and safety of tirzepatide for treatment of overweight or obesity. A systematic review and meta-analysis

Author

Tan, Bryan, Pan, Xin-Hui, Chew, Han Shi Jocelyn, Goh, Rachel Sze Jen, Lin, Chaoxing, Anand, Vickram Vijay, Lee, Ethan Cheng Zhe, Chan, Kai En, Kong, Gwyneth, Ong, Christen En Ya, Chung, Hui Charlotte, Young, Dan Yock, Chan, Mark Y., Khoo, Chin Meng, Mehta, Anurag, Muthiah, Mark Dhinesh, Noureddin, Mazen, Ng, Cheng Han, Chew, Nicholas W. S., and Chin, Yip Han

Published
2023
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19. Impact of Pretransplant Diabetes on Outcomes After Liver Transplantation: An Updated Meta-analysis With Systematic Review

Author

Tang, Ansel Shao Pin, Tan, Caitlyn, Lim, Wen Hui, Ng, Cheng Han, Tan, Darren Jun Hao, Zeng, Rebecca, Xiao, Jieling, Ong, Elden Yen Hng, Cho, Elina, Chung, Charlotte, Lim, Wei Shyann, Chee, Douglas, Nah, Benjamin, Tseng, Michael, Syn, Nicholas, Bonney, Glenn, Liu, Ken, Huang, Daniel Q., Muthiah, Mark, Siddiqui, Mohammad Shadab, and Tan, Eunice X.X.

Published
2024
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21. Clinical characteristics, surveillance, treatment allocation, and outcomes of non-alcoholic fatty liver disease-related hepatocellular carcinoma: a systematic review and meta-analysis

Author

Tan, Darren Jun Hao, Ng, Cheng Han, Lin, Snow Yunni, Pan, Xin Hui, Tay, Phoebe, Lim, Wen Hui, Teng, Margaret, Syn, Nicholas, Lim, Grace, Yong, Jie Ning, Quek, Jingxuan, Xiao, Jieling, Dan, Yock Young, Siddiqui, Mohammad Shadab, Sanyal, Arun J, Muthiah, Mark D, Loomba, Rohit, and Huang, Daniel Q

Subjects
Chronic Liver Disease and Cirrhosis, Rare Diseases, Liver Disease, Digestive Diseases, Liver Cancer, Hepatitis, Cancer, Good Health and Well Being, Carcinoma, Hepatocellular, Child, Cross-Sectional Studies, Humans, Liver Cirrhosis, Liver Neoplasms, Non-alcoholic Fatty Liver Disease, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

BackgroundThe clinical presentation and outcomes of non-alcoholic fatty liver disease (NAFLD)-related hepatocellular carcinoma are unclear when compared with hepatocellular carcinoma due to other causes. We aimed to establish the prevalence, clinical features, surveillance rates, treatment allocation, and outcomes of NAFLD-related hepatocellular carcinoma.MethodsIn this systematic review and meta-analysis, we searched MEDLINE and Embase from inception until Jan 17, 2022, for articles in English that compared clinical features, and outcomes of NAFLD-related hepatocellular carcinoma versus hepatocellular carcinoma due to other causes. We included cross-sectional and longitudinal observational studies and excluded paediatric studies. Study-level data were extracted from the published reports. The primary outcomes were (1) the proportion of hepatocellular carcinoma secondary to NAFLD, (2) comparison of patient and tumour characteristics of NAFLD-related hepatocellular carcinoma versus other causes, and (3) comparison of surveillance, treatment allocation, and overall and disease-free survival outcomes of NAFLD-related versus non-NAFLD-related hepatocellular carcinoma. We analysed proportional data using a generalised linear mixed model. Pairwise meta-analysis was done to obtain odds ratio (OR) or mean difference, comparing NAFLD-related with non-NAFLD-related hepatocellular carcinoma. We evaluated survival outcomes using pooled analysis of hazard ratios.FindingsOf 3631 records identified, 61 studies (done between January, 1980, and May, 2021; 94 636 patients) met inclusion criteria. Overall, the proportion of hepatocellular carcinoma cases secondary to NAFLD was 15·1% (95% CI 11·9-18·9). Patients with NAFLD-related hepatocellular carcinoma were older (p75%), and all articles had low-to-moderate risk of bias.InterpretationNAFLD-related hepatocellular carcinoma is associated with a higher proportion of patients without cirrhosis and lower surveillance rates than hepatocellular carcinoma due to other causes. Surveillance strategies should be developed for patients with NAFLD without cirrhosis who are at high risk of developing hepatocellular carcinoma.FundingNone.

Published
2022

23. Rising global burden of cancer attributable to high BMI from 2010 to 2019

Author

Tan, Darren Jun Hao, Ng, Cheng Han, Muthiah, Mark, Yong, Jie Ning, Chee, Douglas, Teng, Margaret, Wong, Zhen Yu, Zeng, Rebecca Wenling, Chin, Yip Han, Wang, Jiong-Wei, Danpanichkul, Pojsakorn, Rajaram, Ruveena Bhavani, DasGupta, Ramanuj, Suzuki, Hiroyuki, Takahashi, Hirokazu, Tamaki, Nobuharu, Dan, Yock Young, Lui, Rashid, Duseja, Ajay, Siddiqui, Mohammad Shadab, Yeoh, Khay Guan, Sanyal, Arun, Wijarnpreecha, Karn, Loomba, Rohit, Mantzoros, Christos Socrates, and Huang, Daniel Q.

Published
2024
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24. Longitudinal Outcomes Associated With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Meta-analysis of 129 Studies

Author

Chan, Kai En, Ong, Elden Yen Hng, Chung, Charlotte Hui, Ong, Christen En Ya, Koh, Benjamin, Tan, Darren Jun Hao, Lim, Wen Hui, Yong, Jie Ning, Xiao, Jieling, Wong, Zhen Yu, Syn, Nicholas, Kaewdech, Apichat, Teng, Margaret, Wang, Jiong-Wei, Chew, Nicholas, Young, Dan Yock, Know, Alfred, Siddiqui, Mohammad Shadab, Huang, Daniel Q., Tamaki, Nobuharu, Wong, Vincent Wai-Sun, Mantzoros, Christos S., Sanyal, Arun, Noureddin, Mazen, Ng, Cheng Han, and Muthiah, Mark

Published
2024
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25. Donor Diabetes and Steatosis Affects Recipient Survival Following Liver Transplantation Based on Etiology of Liver Cirrhosis

Author

Lim, Wen Hui, Ng, Cheng Han, Tan, Darren Jun Hao, Xiao, Jieling, Fu, Clarissa Elysia, Ong, Christen, Koh, Benjamin, Chung, Charlotte, Tan, Shi Ni, Wong, Zhen Yu, Mitchell, Kimberly, Joseph, Ayana Andrews, Tseng, Michael, Syn, Nicholas, Mak, Lung Yi, Fung, James, Huang, Daniel Q., Muthiah, Mark, Tan, Eunice X.X., and Siddiqui, Mohammad Shadab

Published
2024
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26. Global Prevalence, Clinical Characteristics, Surveillance, Treatment Allocation, and Outcomes of Alcohol-Associated Hepatocellular Carcinoma

Author

Zeng, Rebecca Wenling, Ong, Christen En Ya, Ong, Elden Yen Hng, Chung, Charlotte Hui, Lim, Wen Hui, Xiao, Jieling, Danpanichkul, Pojsakorn, Law, Jia Hao, Syn, Nicholas, Chee, Douglas, Kow, Alfred Wei Chieh, Lee, Sung Won, Takahashi, Hirokazu, Kawaguchi, Takumi, Tamaki, Nobuharu, Dan, Yock Young, Nakajima, Atsushi, Wijarnpreecha, Karn, Muthiah, Mark D., Noureddin, Mazen, Loomba, Rohit, Ioannou, George N., Tan, Darren Jun Hao, Ng, Cheng Han, and Huang, Daniel Q.

Published
2024
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30. The Spectrum and Impact of Metabolic Dysfunction in MAFLD: A Longitudinal Cohort Analysis of 32,683 Overweight and Obese Individuals

Author

Chan, Kai En, Ng, Cheng Han, Fu, Clarissa Elysia, Quek, Jingxuan, Kong, Gwyneth, Goh, Yi Jie, Zeng, Rebecca Wenling, Tseng, Michael, Aggarwal, Manik, Nah, Benjamin, Chee, Douglas, Wong, Zhen Yu, Zhang, Sitong, Wang, Jiong-Wei, Chew, Nicholas W.S., Dan, Yock Young, Siddiqui, Mohammad Shadab, Noureddin, Mazen, Sanyal, Arun J., and Muthiah, Mark

Published
2023
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31. Injectable liposomal docosahexaenoic acid alleviates atherosclerosis progression and enhances plaque stability

Author

Chong, Suet Yen, Wang, Xiaoyuan, van Bloois, Louis, Huang, Chenyuan, Syeda, Nilofer Sayed, Zhang, Sitong, Ting, Hui Jun, Nair, Vaarsha, Lin, Yuanzhe, Lou, Charles Kang Liang, Benetti, Ayca Altay, Yu, Xiaodong, Lim, Nicole Jia Ying, Tan, Michelle Siying, Lim, Hwee Ying, Lim, Sheau Yng, Thiam, Chung Hwee, Looi, Wen Donq, Zharkova, Olga, Chew, Nicholas W.S., Ng, Cheng Han, Bonney, Glenn Kunnath, Muthiah, Mark, Chen, Xiaoyuan, Pastorin, Giorgia, Richards, A. Mark, Angeli, Veronique, Storm, Gert, and Wang, Jiong-Wei

Published
2023
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32. Impact of Pretransplant Diabetes on Outcomes After Liver Transplantation: An Updated Meta-analysis With Systematic Review

Author

Tang, Ansel Shao Pin, Tan, Caitlyn, Lim, Wen Hui, Ng, Cheng Han, Tan, Darren Jun Hao, Zeng, Rebecca, Xiao, Jieling, Ong, Elden Yen Hng, Cho, Elina, Chung, Charlotte, Lim, Wei Shyann, Chee, Douglas, Nah, Benjamin, Tseng, Michael, Syn, Nicholas, Bonney, Glenn, Liu, Ken, Huang, Daniel Q., Muthiah, Mark, Siddiqui, Mohammad Shadab, and Tan, Eunice XX

Published
2023
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34. Hepatic, Extra-hepatic Outcomes and Causes of Mortality in NAFLD – An Umbrella Overview of Systematic Review of Meta-Analysis

Author

Xiao, Jieling, Ng, Cheng Han, Chan, Kai En, Fu, Clarissa, Tay, Phoebe, Yong, Jie Ning, Lim, Wen Hui, Tan, Darren Jun Hao, Syn, Nicholas, Wong, Zhen Yu, Tseng, Michael, Chew, Nicholas, Huang, Daniel Q., Dan, Yock Yong, Wong, Vincent Wai-Sun, Loomba, Rohit, Siddiqui, Mohammad S., Sanyal, Arun J., Noureddin, Mazen, and Muthiah, Mark D.

Published
2023
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35. Comparative Burden of Metabolic Dysfunction in Lean NAFLD vs Non-lean NAFLD - A Systematic Review and Meta-analysis

Author

Tang, Ansel, Ng, Cheng Han, Phang, Poh Hui, Chan, Kai En, Chin, Yip Han, Fu, Clarissa Elysia, Zeng, Rebecca Wenling, Xiao, Jieling, Tan, Darren Jun Hao, Quek, Jingxuan, Lim, Wen Hui, Mak, Lung Yi, Wang, Jiong-wei, Chew, Nicholas W.S., Syn, Nicholas, Huang, Daniel Q., Siddiqui, Mohammad Shadab, Sanyal, Arun, Muthiah, Mark, and Noureddin, Mazen

Published
2023
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36. UNOS Down-Staging Criteria for Liver Transplantation of Hepatocellular Carcinoma: Systematic Review and Meta-Analysis of 25 Studies

Author

Tan, Darren Jun Hao, Lim, Wen.Hui, Yong, Jie Ning, Ng, Cheng Han, Muthiah, Mark D., Tan, Eunice X., Xiao, Jieling, Lim, Snow Yunni, Pin Tang, Ansel Shao, Pan, Xin Hui, Kabir, Tousif, Bonney, Glenn K., Sundar, Raghav, Syn, Nicholas, Kim, Beom Kyung, Dan, Yock Young, Noureddin, Mazen, Loomba, Rohit, and Huang, Daniel Q.

Published
2023
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37. Barriers and Facilitators to Engagement With a Weight Management Intervention in Asian Patients With Overweight or Obesity: A Systematic Review

Author

Anand, Vickram Vijay, Zhe, Ethan Lee Cheng, Chin, Yip Han, Lim, Wen Hui, Goh, Rachel Sze Jen, Lin, Chaoxing, Ng, Cheng Han, Kong, Gwyneth, Tay, Phoebe Wen Lin, Devi, Kamala, Muthiah, Mark, Singh, Vijai, Chu, Dinh-Toi, Khoo, Chin Meng, Chan, Mark Y., Dimitriadis, Georgios K., Foo, Roger, and Chew, Nicholas W.S.

Published
2023
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40. The global syndemic of metabolic diseases in the young adult population: A consortium of trends and projections from the Global Burden of Disease 2000–2019

Author

Chong, Bryan, Kong, Gwyneth, Shankar, Kannan, Chew, H.S. Jocelyn, Lin, Chaoxing, Goh, Rachel, Chin, Yip Han, Tan, Darren Jun Hao, Chan, Kai En, Lim, Wen Hui, Syn, Nicholas, Chan, Siew Pang, Wang, Jiong-Wei, Khoo, Chin Meng, Dimitriadis, Georgios K., Wijarnpreecha, Karn, Sanyal, Arun, Noureddin, Mazen, Siddiqui, Mohammad Shadab, Foo, Roger, Mehta, Anurag, Figtree, Gemma A., Hausenloy, Derek J., Chan, Mark Y., Ng, Cheng Han, Muthiah, Mark, Mamas, Mamas A., and Chew, Nicholas W.S.

Published
2023
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41. Trends and predictions of malnutrition and obesity in 204 countries and territories: an analysis of the Global Burden of Disease Study 2019

Author

Chong, Bryan, Jayabaskaran, Jayanth, Kong, Gwyneth, Chan, Yiong Huak, Chin, Yip Han, Goh, Rachel, Kannan, Shankar, Ng, Cheng Han, Loong, Shaun, Kueh, Martin Tze Wah, Lin, Chaoxing, Anand, Vickram Vijay, Lee, Ethan Cheng Zhe, Chew, H.S. Jocelyn, Tan, Darren Jun Hao, Chan, Kai En, Wang, Jiong-Wei, Muthiah, Mark, Dimitriadis, Georgios K., Hausenloy, Derek J., Mehta, Anurag J., Foo, Roger, Lip, Gregory, Chan, Mark Y., Mamas, Mamas A., le Roux, Carel W., and Chew, Nicholas W.S.

Published
2023
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43. Donor Diabetes and Steatosis Affects Recipient Survival Following Liver Transplantation Based on Etiology of Liver Cirrhosis

Author

Lim, Wen Hui, Ng, Cheng Han, Tan, Darren Jun Hao, Xiao, Jieling, Fu, Clarissa Elysia, Ong, Christen, Koh, Benjamin, Chung, Charlotte, Tan, Shi Ni, Wong, Zhen Yu, Mitchell, Kimberly, Joseph, Ayana Andrews, Tseng, Michael, Syn, Nicholas, Mak, Lung Yi, Fung, James, Huang, Daniel Q., Muthiah, Mark, Tan, Eunice X.X., and Siddiqui, Mohammad Shadab

Published
2023
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45. Global prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in the overweight and obese population: a systematic review and meta-analysis

Author

Quek, Jingxuan, Chan, Kai En, Wong, Zhen Yu, Tan, Caitlyn, Tan, Bryan, Lim, Wen Hui, Tan, Darren Jun Hao, Tang, Ansel Shao Pin, Tay, Phoebe, Xiao, Jieling, Yong, Jie Ning, Zeng, Rebecca Wenling, Chew, Nicholas W S, Nah, Benjamin, Kulkarni, Anand, Siddiqui, Mohammad Shadab, Dan, Yock Young, Wong, Vincent Wai-Sun, Sanyal, Arun J, Noureddin, Mazen, Muthiah, Mark, and Ng, Cheng Han

Published
2023
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46. Type 2 diabetes mellitus in metabolic-associated fatty liver disease vs. type 2 diabetes mellitus non-alcoholic fatty liver disease: a longitudinal cohort analysis

Author

Muthiah, Mark, Ng, Cheng Han, Chan, Kai En, Fu, Clarissa Elysia, Lim, Wen Hui, Tan, Darren Jun Hao, Nah, Benjamin, Kong, Gwyneth, Xiao, Jieling, Yong, Jie Ning, Tan, Bryan, Syn, Nicholas, Wang, Jiong-Wei, Sayed, Nilofer, Tan, Eunice, Chew, Nicholas WS, Dan, Yock Young, Siddiqui, Mohammad Shadab, Sanyal, Arun J., and Noureddin, Mazen

Published
2023
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48. WED-282 Prevalence of LowFibrosis-4 Score in Patients with MASLD-related Hepatocellular Carcinoma: Results from a Multicentre Cohort Study

Author

Sim, Benedix, primary, Tamaki, Nobuharu, additional, Kim, Beom Kyung, additional, Wijarnpreecha, Karn, additional, Tan, Darren Jun Hao, additional, Aboona, Majd, additional, Faulkner, Claire, additional, Liu, Ken, additional, Lim, Wen Hui, additional, Syn, Nicholas, additional, Ng, Cheng Han, additional, Tung, Daniel, additional, Tay, Benjamin, additional, Tey, Yi Qing, additional, Mok, John, additional, Nah, Benjamin, additional, Costa, Maureen da, additional, Iyer, Shridhar, additional, Bonney, Glenn, additional, Kow, Alfred, additional, Muthiah, Mark, additional, Teng, Margaret, additional, KulkarnI, Anand, additional, Lee, Sung Won, additional, Loomba, Rohit, additional, and Huang, Daniel, additional

Published
2024
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49. SAT-281 Clinical characteristics, surveillance, treatment allocation and outcomes of alcohol-related hepatocellular carcinoma: meta-analysis of 37 studies and 66, 559 patients

Author

Tung, Daniel, primary, Zeng, Rebecca Wenling, additional, En Ya Ong, Christen, additional, Ong, Elden, additional, Hui Ong, Charlotte Chung, additional, Sim, Benedix, additional, Koh, Jia Hong, additional, Lim, Wen Hui, additional, Xiao, Jieling, additional, Syn, Nicholas, additional, Kow, Alfred, additional, Ng, Cheng Han, additional, Hao Tan, Darren Jun, additional, Lee, Sung Won, additional, Takahashi, Hirokazu, additional, KawaguchI, Takumi, additional, Tamaki, Nobuharu, additional, Nakajima, Atsushi, additional, Dan, Yock-Young, additional, Wijarnpreecha, Karn, additional, Noureddin, Mazen, additional, Ioannou, George, additional, Muthiah, Mark, additional, Teng, Margaret, additional, Loomba, Rohit, additional, and Huang, Daniel, additional

Published
2024
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50. SAT-256 Liver-related complications are the fastest growing cause of mortality from alcohol consumption: results from the global burden of disease 2019 study

Author

Sim, Benedix, primary, Danpanichkul, Pojsakorn, additional, Hao Tan, Darren Jun, additional, Ng, Cheng Han, additional, Lim, Wen Hui, additional, Nah, Benjamin, additional, Koh, Benjamin, additional, Ong, Christen, additional, Syn, Nicholas, additional, Koh, Jia Hong, additional, Tung, Daniel, additional, Wijarnpreecha, Karn, additional, Muthiah, Mark, additional, Teng, Margaret, additional, and Huang, Daniel, additional

Published
2024
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