Browsing by Author "Lucey, Michael R."

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    Metabolic dysfunction and alcohol-related liver disease (MetALD): Position statement by an expert panel on alcohol-related liver disease
    (2025) Arab Verdugo, Juan Pablo; Díaz Piga, Luis Antonio; Rehm, Jürgen; Im, Gene; Arrese, Marco; Kamath, Patrick S.; Lucey, Michael R.; Mellinger, Jessica; Thiele, Maja; Thursz, Mark; Bataller, Ramon; Burton, Robyn; Chokshi, Shilpa; Francque, Sven M.; Krag, Aleksander; Lackner, Carolin; Lee, Brian; Liangpunsakul, Suthat; MacClain, Craig; Mandrekar, Pranoti; Mitchell, Mack C.; Morgan, Marsha Y.
    In this position statement, we explore the intricate relationship between alcohol intake and metabolic dysfunction in the context of the 2023 nomenclature update for steatotic liver disease (SLD). Recent and lifetime alcohol use should be accurately assessed in all patients with SLD to facilitate classification of alcohol use in grams of alcohol per week. Alcohol biomarkers (i.e., phosphatidylethanol), use of validated questionnaires (i.e. AUDIT-C [alcohol use disorders identification test consumption]), and collateral information from friends and relatives could help facilitate differentiation between alcohol-related liver disease (ALD) per se and liver disease with both metabolic and alcohol-related components (MetALD). Heavy alcohol use can contribute to cardiometabolic risk factors such as high blood pressure, hypertriglyceridaemia, and hyperglycaemia. As a result, caution should be exercised in the application of only one metabolic dysfunction criterion to diagnose MASLD, as suggested in the 2023 nomenclature document, particularly in individuals exceeding weekly alcohol use thresholds of 140 g for women and 210 g for men. This is particularly important in those individuals with isolated high blood pressure, hypertriglyceridaemia, or hyperglycaemia, where the disease process may be driven by alcohol itself. Additionally, metabolic dysfunction and alcohol use should be reassessed over time, especially after periods of change in risk factor exposure. This approach could ensure a more accurate prognosis and effective management of SLD, addressing both metabolic and alcohol-related factors.
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    Provider Attitudes and Practices for Alcohol Screening, Treatment, and Education in Patients With Liver Disease: A Survey From the American Association for the Study of Liver Diseases Alcohol-Associated Liver Disease Special Interest Group
    (2021) Im, Gene Y.; Mellinger, Jessica L.; Winters, Adam; Aby, Elizabeth S.; Lominadze, Zurabi; Rice, John; Lucey, Michael R.; Arab, Juan P.; Goel, Aparna; Jophlin, Loretta L.; Sherman, Courtney B.; Parker, Richard; Chen, Po-Hung; Devuni, Deepika; Sidhu, Sandeep; Dunn, Winston; Szabo, Gyongyi; Singal, Ashwani K.; Shah, Vijay H.
    BACKGROUND & AIMS: While abstinence-promoting behavioral and pharmacotherapies are part of the therapeutic foundation for alcohol use disorder (AUD) and alcohol-associated liver disease (ALD), these therapies, along with alcohol screening and education, are often underutilized. Our aim was to examine provider attitudes and practices for alcohol screening, treatment and education in patients with liver disease.
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    Trajectory of Serum Bilirubin Predicts Spontaneous Recovery in a Real-World Cohort of Patients With Alcoholic Hepatitis
    (2022) Parker, Richard; Cabezas, Joaquin; Altamirano, Jose; Arab, Juan Pablo; Ventura-Cots, Meritxell; Sinha, Ashish; Dhanda, Ashwin; Arrese, Marco; McCune, C. Anne; Rowe, Ian A.; Schnabl, Bernd; Mathurin, Phillipe; Shawcross, Debbie; Abraldes, Juan G.; Lucey, Michael R.; Garcia-Tsao, Guadalupe; Verna, Elizabeth; Brown, Robert S., Jr.; Bosques-Padilla, Francisco; Vargas, Victor; Louvet, Alexandre; Holt, Andrew P.; Bataller, Ramon
    BACKGROUND AND AIMS: Alcoholic hepatitis (AH) is a severe condition with poor short-term prognosis. Specific treatment with corticosteroids slightly improves short-term survival but is associated with infection and is not used in many centers. A reliable method to identify patients who will recover spontaneously will minimise the numbers of patients who experience side effects of available treatments.