NAFLD, NASH
Conditions
Brief summary
The prevalence of Metabolic dysfunction-associated steatotic liver disease (MASLD) and its severe form, Metabolic dysfunction-associated steatohepatitis (MASH), is high and they are increasingly becoming major causes of cirrhosis, hepatocellular carcinoma (HCC), and the need for liver transplantation. Due to the lack of noticeable symptoms during the early stages, the detection of MASLD is often delayed until the disease has advanced. Currently, the treatment options MASLD are limited to lifestyle interventions such as dietary changes and physical activity. Despite the increasing prevalence of MASLD, there are no drugs available on the market specifically for this condition. The goal is to made new model care which integrates the standard clinical procedures with a digital approach, namely a mobile application for patients and a clinical dashboard for healthcare professionals (HCPs), integrated with simple clinical data (anthropometric, laboratory and imaging data). This study wants to test the feasibility of integrating a digital intervention to improve the patient engagement and linkage to care in order to identify the advanced MASLD at earliest stage (secondary prevention) and mitigate the impact of ongoing advanced liver disease helping patients to manage the long-term effect of disease. To achieve this goal the study will leverage on a mobile app named OpenTele in order to test the adherence to lifestyle changes in patient with MASLD and on the connected clinical dashboard. The app aims at integrating the standard clinical practice with digital technologies able to guide and support patients in order to seamlessly integrate secondary prevention strategies in their everyday life with 2 main aims: * to implement a strategy for delay progression of liver disease; * to reduce the effect of cirrhosis (tertiary prevention).
Interventions
None listed
Sponsors
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Diagnosed with MASLD and LSM\>= 10 kPa * Age \>= 18 years old * Sufficient digital literacy or supported from a caregiver with sufficient digital literacy * Smartphone (Android or iOS) able to download and run the App * Able to understand and communicate in Italian * Able to sign the informed consent
Exclusion criteria
* Major psychiatric disorder * Not able to use digital technologies
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| App Adherence (>80% over 4 weeks) | 4 weeks | Assessed via smartphone (number of app access) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Weight reduction assessment | 12 month | Number of subjects with a 12-month reduction between 7-10% of weight compared to baseline |
| Change in liver and spleen stiffness | Baseline, after 4 weeks and 12 month | Assessed by transient elastography |
| Change in Patient Reported Outcome questionnaire | 12 weeks | Evaluation of overall physical well-being through the administration of questionnaires |
| Changes in measure energy expenditure | 12 month | Cycle ergometer |
| Microbiome signature | 12 month | Analysis of microbiome signature from feces |
| Clinical events | 12 month | Record of number of hospitalization, decompensation, variceal bleeding, encephalopathy, ascites, liver cancer, liver transplantation, death |
Countries
Italy
Contacts
CONTACTLuca Miele
PRINCIPAL_INVESTIGATORLuca Miele
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Outcome results
None listed