{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:22:42Z","timestamp":1792462962009,"version":"4.5.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Nonalcoholic steatohepatitis (NASH) is a prevalent chronic disease that is associated with a spectrum of liver fibrosis and can lead to cirrhosis. Patients with NASH report lower health\u2010related quality of life (HRQoL) than the general population. It remains uncertain how changes in histologic severity are associated with changes in HRQoL. This is a secondary analysis of the Farnesoid X Receptor Ligand Obeticholic Acid in NASH Treatment (FLINT) and Pioglitazone, Vitamin E, or Placebo for Nonalcoholic Steatohepatitis (PIVENS) randomized controlled trials in patients with biopsy\u2010proven NASH. HRQoL was assessed using short form\u201036 at baseline and at follow\u2010up biopsy (at 72 and 96\u2009weeks, respectively). Adjusted linear regression models were used to examine the association between changes in liver fibrosis (primary analysis), nonalcoholic fatty liver disease (NAFLD) activity score (secondary analysis), and changes in HRQoL scores. Compared with stable fibrosis, improvement of fibrosis by at least one stage was significantly associated with improvements only in the physical function component by 1.8 points (95% confidence interval, 0.1, 3.5). Worsening of fibrosis by at least one stage was not associated with statistically significant changes in any HRQoL domain compared with stable fibrosis. Associations between HRQoL and NAFLD disease activity score in the secondary analysis were of similar magnitude. Weight loss was associated with small improvements in physical function, general health, and energy levels.\n                    <jats:italic toggle=\"yes\">Conclusion<\/jats:italic>\n                    : Improvements in fibrosis stage were associated with improvements in the physical component of HRQoL, but the clinical impact was modest. As improving fibrosis may not meaningfully improve well\u2010being, treatment for NASH will be cost effective only if it prevents long\u2010term hepatic and cardiovascular disease.\n                  <\/jats:p>","DOI":"10.1002\/hep4.2044","type":"journal-article","created":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T02:19:02Z","timestamp":1659061142000},"page":"2623-2633","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Association of changes in histologic severity of nonalcoholic steatohepatitis and changes in patient\u2010reported quality of life"],"prefix":"10.1097","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1628-1981","authenticated-orcid":false,"given":"Laura","family":"Heath","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences,University of Oxford,Oxford,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Aveyard","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences,University of Oxford,Oxford,UK"},{"name":"National Institute for Health Research (NIHR) Oxford Biomedical Research Centre,Oxford University Hospitals NHS Foundation Trust,Oxford,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy W.","family":"Tomlinson","sequence":"additional","affiliation":[{"name":"Oxford Centre for Diabetes,Endocrinology and Metabolism,NIHR Oxford Biomedical Research Centre,University of Oxford,Churchill Hospital,Oxford,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy F.","family":"Cobbold","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology,NIHR Oxford Biomedical Research Centre,Oxford University Hospitals NHS Foundation Trust,John Radcliffe Hospital,Oxford,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1955-7234","authenticated-orcid":false,"given":"Dimitrios A.","family":"Koutoukidis","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences,University of Oxford,Oxford,UK"},{"name":"National Institute for Health Research (NIHR) Oxford Biomedical Research Centre,Oxford University Hospitals NHS Foundation Trust,Oxford,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"issue":"1","key":"hep42044-bib-0001-20241127","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/hep.28431","article-title":"Global epidemiology of nonalcoholic fatty liver disease\u2010meta\u2010analytic assessment of prevalence, incidence, and 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