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Lookup NU author(s): Professor Quentin AnsteeORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2025Background & Aims: The impact of metabolic dysfunction-associated steatohepatitis (MASH) on patient-reported outcomes is poorly understood. We assessed work productivity burden in a real-world population with suspected/confirmed MASH, comparing work productivity and symptoms across subgroups (risk status, age, BMI, and comorbidities) in the USA using secondary data from Adelphi Real World MASH Disease Specific Programmes™, cross-sectional surveys of physicians and consulting patients in 2019 and 2022. Methods: Physicians (hepatologists, gastroenterologists, and endocrinologists) reported sociodemographic data and signs/symptoms for eight or fewer consecutive participants with MASH. Participants voluntarily completing questionnaires that assessed work productivity, health status, and quality of life/symptoms were categorized with low-, indeterminate-, or high-risk MASH using physician-stated fibrosis stage and derived risk categories. Principal components factor analysis identified factors from MASH signs and symptoms. Elastic net regression determined features associated with work productivity impairment. Results: In total, 87 physicians and 429 individuals with MASH provided data. The impact of MASH on activities was greater in high-versus low-risk MASH (activity impairment score: high risk, 30.8%; low risk, 17%; p <0.001 across all risk categories). Overall work impairment scores were 18.8% in low-risk and 19.9% in high-risk MASH. Of the 14 physician-reported signs/symptoms, 11 were significantly associated with physician-stated fibrosis stage and/or derived risk category. Two clusters of signs and symptoms (‘memory loss/swelling legs/abdomen’ and ‘fatigue/sleep disturbance/insomnia/general weakness’) and female sex were the strongest work impact predictors. Conclusions: Activity impairment was greater in participants with high-risk MASH, whereas overall work impairment was comparable, almost 20%, in low- and high-risk MASH. Non-specific symptoms of fatigue, sleep disturbance, and general weakness associated with MASH and other conditions predicted work impact in low-risk MASH. Thus, early detection and management of MASH could ameliorate work impairment. Impact and implications: Even in its early stages, when otherwise asymptomatic, metabolic dysfunction-associated steatohepatitis (MASH) may impact the ability to work. Using the Work Productivity and Activity Impairment: Specific Health Problem (WPAI:SHP) questionnaire, we identified activity and overall work impairment in people with high- and low-risk MASH. We found a link between difficulty working and other signs, such as tiredness, sleep disturbance, and general weakness, in low-risk MASH that are not specific to MASH but can be associated with liver health. These general, non-specific signs could represent possible early warning signs preceding reduced productivity in patients with MASH.
Author(s): Shinde S, Rinella ME, Hartman ML, Schapiro D, Higgins V, Leith A, Pike J, Anstee QM
Publication type: Article
Publication status: Published
Journal: JHEP Reports
Year: 2025
Volume: 7
Issue: 11
Print publication date: 01/11/2025
Online publication date: 22/08/2025
Acceptance date: 13/08/2025
Date deposited: 20/10/2025
ISSN (electronic): 2589-5559
Publisher: Elsevier B.V.
URL: https://doi.org/10.1016/j.jhepr.2025.101558
DOI: 10.1016/j.jhepr.2025.101558
Data Access Statement: All data (i.e., methodology, materials, data and data analysis) that support the findings of this survey are the intellectual property of Adelphi Real World. All requests for access should be addressed directly to Victoria Higgins at victoria.higgins@omc.com.
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