title: Clinical trial watch: reports from the AASLD Liver Meeting®, Boston, November 2014.
abstract: The late and fast developments in the field of viral hepatitis were highly expected in the 2014 AASLD Liver Meeting®. Several combinations using direct acting antivirals (DAAs) showed high rates of sustained virological response (∼95%). Importantly, high cure rates were also demonstrated in patients with previous treatment failures, decompensated cirrhosis and hepatitis C recurrence after transplantation, making it clear that the interferon era is over (not so clear for ribavirin, which might still have a role in difficult-to-treat populations). Importantly, sustained virological response was associated with an improvement in liver function (MELD and Child-Pugh scores) in patients with advanced liver disease. In the field of liver cirrhosis, there were relevant data assessing the optimal empirical antibiotic therapy in patients with spontaneous bacterial peritonitis and high risk of resistant bacteria, as well as studies evaluating the role of terlipressin in type I hepatorenal syndrome and in septic shock. Regarding hepatic encephalopathy, two randomized trials suggest that the manipulation of the microbioma in patients with cirrhosis may have a role in the management of this complication. Some novel data on NASH support the beneficial effect of bariatric surgery (after failure of lifestyle intervention) in morbid obese patients with such diagnosis: clinical and histological improvements after surgery were evident in most patients with sufficient follow-up. A few controlled studies focused on the treatment of severe acute alcoholic hepatitis. Finally, several studies on hepatocellular carcinoma (HCC) were presented, covering topics such as ultrasound screening in cirrhosis, cryoablation treatment of early HCC and the relevance of downstaging in patients with HCC awaiting liver transplantation.
authors: Liver Unit, Hospital Clínic, IDIBAPS and CIBEREHD, University of Barcelona, Barcelona, Spain.
authors: María-Carlota
authors: MC
authors: Londoño
authors: Cirrhosis Care Clinic (CCC), Liver Unit, Division of Gastroenterology, University of Alberta, Edmonton, Canada.
authors: Juan G
authors: JG
authors: Abraldes
authors: Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain.
authors: José
authors: J
authors: Altamirano
authors: Universités de Grenoble, CHU de Grenoble, Pôle DIGI-DUNE, Service d'Hépatologie et de Gastroentérologie, INSERM U823, Institut Albert Bonniot, Grenoble, France.
authors: Thomas
authors: T
authors: Decaens
authors: Liver Unit, Hospital Clínic, IDIBAPS and CIBEREHD, University of Barcelona, Barcelona, Spain. Electronic address: xforns@clinic.ub.es.
authors: Xavier
authors: X
authors: Forns
mesh_terms: D002986:Clinical Trials as Topic; D003226:Congresses as Topic; D019468:Disease Management; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000628:therapy
keywords: Hepatitis; Hepatocellular carcinoma; NASH; Portal hypertension