Meet the Experts: Multidisciplinary approach for management of alcohol related liver disease

 Metabolism, alcohol and toxicity

Stolz 1
Meet the Experts
12 April 2019 11:30 - 12:20

Questions for discussion:

  • When shall we screen at risk individuals with alcohol overuse for fibrosis or cirrhosis. If so how: Imaging, liver function test or something else? and how frequent and in case of fibrosis how should they be followed i.e. HCC, varices, drugs, lifestyle?
  • While waiting for targeted therapies in ALD how do we as hepatologists take best care of our patients with alcoholic fatty liver and liver fibrosis: When to biopsy and how to risk stratify.
  • Alcohol abstinence is the cornerstone of the therapy in AUD patients with liver disease In AUD patients, the combination between psychosocial intervention and pharmacological therapy is the most effective strategy to induce alcohol abstinence and prevent relapse. However, treatments for AUD have not been formally tested in patients with liver disease other than Baclofen. In particular at present the pharmacological choice for these patients is very limited. How do we best tackle this issue?
  • Psychosocial approach is an important component for the management of these patients. However, also psychosocial approaches have been mainly tested in AUD patients without LD. Psychosocial intervention became crucial in these patients considering the limited available pharmacological treatment. How do we improve studies on this topic?
  • While alcohol rehabilitation is the cornerstone in ALD, the overall success of lifestyle changes is low and the risk of progression to cirrhosis high. What specific interventions is it relevant to investigate as potential treatment targets to halt or treat alcoholic liver fibrosis.
  • Alcohol is the leading cause of liver disease and liver related deaths globally, by far exceeding NAFLD/NASH, still companies’ drug pipelines and academic access to funding is scarce. What are the barriers and how can we break them down to advance the field and respond to the societal challenge?
  • AUDs is a complex disease and evidences from literature data support the useful of multidisciplinary management. However which is the most appropriate team to manage AUD patients with liver disease? Does this team headed by Psychiatrist? Hepatologist? At present the team and the optimal setting to manage AUD patients with liver disease still needs to be defined