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The American Association for the Study of Liver Diseases sponsored an endpoints conference to help accelerate the efficient testing of antifibrotic agents and develop recommendations on clinical trial design for liver fibrosis. In this review, we summarize the salient and novel elements of this conference and provide directions for future clinical trial design. The article follows the structure of the conference and is organized into five areas: (1) antifibrotic trial design; (2) preclinical proof\u2010of\u2010concept studies; (3) pharmacological targets, including rationale and lessons to learn; (4) rational drug design and development; and (5) consensus and recommendations on design of clinical trials in liver fibrosis. Expert overviews and collaborative discussions helped to summarize the key unmet needs and directions for the future, including: (1) greater clarification of at\u2010risk populations and study groups; (2) standardization of all elements of drug discovery and testing; (3) standardization of clinical trial approaches; (4) accelerated development of improved noninvasive markers; and (5) need for exploration of potential off\u2010target toxicities of future antifibrotic drugs. (H<jats:sc>epatology<\/jats:sc> 2015;62:627\u2013634<\/jats:p>","DOI":"10.1002\/hep.27720","type":"journal-article","created":{"date-parts":[[2015,1,27]],"date-time":"2015-01-27T16:16:46Z","timestamp":1422375406000},"page":"627-634","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":66,"title":["Strategies and endpoints of antifibrotic drug trials: Summary and recommendations from the AASLD Emerging Trends Conference, Chicago, June 2014"],"prefix":"10.1097","volume":"62","author":[{"given":"Natalie J.","family":"Torok","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology,UC Davis Medical Center, Sacramento,CA and VA Northern California Healthcare System,Mather CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A.","family":"Dranoff","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,University of Arkansas for Medical Sciences,Little Rock, AR, and Research Service, Central Arkansas VA Healthcare System,Little Rock,AR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Detlef","family":"Schuppan","sequence":"additional","affiliation":[{"name":"Institute of Translational Immunology and Research Center for Immunotherapy,University Medical Center,Mainz,Germany"},{"name":"Division of Gastroenterology,Beth Israel Deaconess Medical Center, Harvard Medical School,Boston,MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Liver Diseases,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2015,3,10]]},"reference":[{"key":"hep27720-bib-0001-20241017","doi-asserted-by":"crossref","first-page":"170","DOI":"10.7326\/M14-0095","article-title":"The changing burden of hepatitis C virus infection 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