News & Events
Published On: 11/4/2022
New TARGET-NASH Real World Data Show Non-Alcoholic Fatty Liver Disease Severity and Gender Linked to Disparities in Polypharmacy
DURHAM, N.C., Nov. 4, 2022 /PRNewswire/ -- New data presented today by Target RWE highlights polypharmacy disparities in gender and disease among people with liver disease in terms of the type and number of medications they are prescribed. The study, "The Role of Disease Severity and Gender in Polypharmacy Among Patients with NAFLD Enrolled in TARGET-NASH," was presented in Washington, DC at The Liver Meeting®, the annual congress of the American Association for the Study of Liver Diseases.
"Among patients with non-alcoholic fatty liver disease (NAFLD), those with non-alcoholic steatohepatitis (NASH) cirrhosis are most affected by polypharmacy, with female cirrhotics at a greater risk of polypharmacy," said Leen Al-Sayyed, M.D., Chief Gastroenterology-Transplant Hepatology Fellow at Saint Louis University, and first author on the study. "This research highlights the value of real-world data in tracking treatment of a growing population that face numerous complex health issues."
"Polypharmacy is a rising issue among adults, especially elderly and those with multiple comorbidities," said Brent Tetri, M.D., Professor of Internal Medicine at Saint Louis University and last author of the study. "We found a strong correlation between disease severity and chronic pain. Opioid, benzodiazepine and non-steroidal anti-inflammatory drug (NSAID) use is prevalent among cirrhotics despite the risk of inducing or worsening the underlying disease. Medication use for chronic pain is prevalent in patients with cirrhosis highlighting the need for management plans that optimize safety balanced against therapeutic efficacy."
Research highlights include:
- 75% of patients were on more than five medications, and 37% were prescribed 10 or more medications (69% of whom were females)
- The median number of medications used in females was nine compared to seven in males
- As liver disease severity increased, so did the likelihood of having a comorbid disease. Chronic pain increased with liver disease severity and occurred in almost 50% of cirrhotic participants who were treated with benzodiazepines (22%), opioids (36%), NSAIDs (50%) and proton-pump inhibitors (PPIs) (67%)
- Female patients were on more medications than males, particularly selective serotonin reuptake inhibitors (SSRIs) (46% vs 23%), opioids (30% vs 23%), vitamins (52% vs 41%), PPIs (58% vs 47%) and benzodiazepines (24% vs 13%)
The final study population included 4,562 patients (58% female) with the following disease phenotypes at index date: 18% NAFL, 44% NASH and 38% NAFLD cirrhosis. The median age was 52, about 70% were White and 11% Hispanic. Most subjects in this study were on at least one medication prior to enrollment and roughly 20% initiated a new medication after enrollment.
Sponsored by Target RWE, TARGET-NASH is a longitudinal, observational cohort of adult and pediatric participants with NAFLD and/or NASH receiving usual care from academic and community centers in the U.S. and Europe, enrolling over 7,000 participants to date. Real-world data is collected from consented participants, who may also provide patient-reported outcome measures and biospecimens. Learn about TARGET-NASH publications here.
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