Clinical Performance of LIVERFASt Tests Compared With Liver Biopsy in Patients With Non-Alcoholic Fatty Liver Disease (NAFLD).

  • End date
    Sep 30, 2021
  • participants needed
  • sponsor
    Fibronostics USA, Inc
Updated on 1 February 2021


The primary objective of this study is to assess the clinical performance of LIVERFAStTM In Vitro Diagnostic (IVD) Tests (Fibrosis score, Activity score and Steatosis score) in NAFLD suspected patients for staging of fibrosis and for grading of inflammatory activity and steatosis, taking as reference the liver biopsy with histological classification of the elementary lesions determined according to SAF scores (Bedossa P., Hepatology 2012).

The secondary objective is to assess the performance of LIVERFAStTM for the histological definition of NAFLD, including NAFL and NASH and severe NASH


Chronic liver diseases (CLDs), such as chronic viral hepatitis, nonalcoholic fatty liver diseases (NAFLD) and nonalcoholic steatohepatitis (NASH), are a leading cause of morbidity and mortality globally and usually develops over many years. The prevalence of NAFLD has increased in recent years (15% in 2005 to 25% in 2010) mainly due to the increase prevalence of obesity and diabetes. As, approximately 20% of NAFLD cases develop NASH, the associated increase in NASH during the same period is to be expected (33% in 2005 to 59.1% in 2010).

As a result, staging of liver fibrosis is essential in determining the prognosis and optimal treatment for patients with NASH. Furthermore, evaluation of fibrosis in NAFLD patients can help refine treatment options designed to prevent the progression to NASH.

One recent study demonstrates significant sampling variability of routine liver biopsy in patients with NAFLD (Ratziu V. et al. Gastroenterology 2008). The diagnosis of NASH would have been missed in 35% and the discordance for steatosis grading was encountered in 22% of patients.

Developing safe and easily accessible noninvasive modalities to accurately evaluate fibrosis stage of NAFLD and NASH is of utmost importance in clinical practice.

Fibronostics breaks through the burden to serve patients. By empowering their providers with IVD clinical tools within the clinic, the ability to ensure screening and clinical adherence is assured, and the ease for early detection profoundly shifts the $2B economic burden.

LIVERFASt is a non-invasive clinical and staging In-Vitro-Diagnostic (IVD) tool, which has been developed as an alternative to liver biopsy. LIVERFASt is a safe, and reproducible tool which provides surrogate grading and staging of the three elementary features of NASH: steatosis, inflammatory activity and fibrosis.

LIVERFAStTM combines age, gender, weight and height with common liver function tests (ALT, AST, GGT, total bilirubin), lipid profile (total cholesterol, triglycerides), fasting glucose and three specific proteins of the liver with hepatoprotective functions and predictive value in NAFLD -alpha2-macroglobulin (A2M), haptoglobin (HAP) and apolipoprotein A1 (APOA1).

The main aim of this study is to evaluate the clinical value of LIVERFAStTM as a non-invasive biopsy-proven surrogate assessment of non-alcoholic fatty liver disease.

This is a cohort cross-sectional prospective, multi-centre study of an algorithm-based assessment of liver fibrosis, inflammatory activity (steatohepatitis) and steatosis compared to the histological assessment provided by liver biopsy performed in patients with suspected non-alcoholic steatohepatitis (NASH).

Condition Fatty Liver, Cirrhosis, LIVER DISEASE, Hepatitis, NAFLD, Non-alcoholic Fatty Liver Disease, Nonalcoholic Steatohepatitis (NASH), Nonalcoholic Fatty Liver Disease, Non Alcoholic Steatohepatitis, Non Alcoholic Fatty Liver Disease, Hepatic Fibrosis, Liver Disorders, Non-alcoholic Fatty Liver Disease, liver fibrosis, non-alcoholic fatty liver, steatohepatitis
Treatment LIVERFASt
Clinical Study IdentifierNCT04579874
SponsorFibronostics USA, Inc
Last Modified on1 February 2021


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Inclusion Criteria

Is your age between 18 yrs and 80 yrs?
Gender: Male or Female
Do you have any of these conditions: steatohepatitis or Non Alcoholic Steatohepatitis or Fatty Liver or Non Alcoholic Fatty Liver Disease or non-alcoholic fatty liver or Hepatic Fibrosis ...?
Do you have any of these conditions: Nonalcoholic Fatty Liver Disease or Nonalcoholic Steatohepatitis (NASH) or Hepatitis or NAFLD or Non Alcoholic Steatohepatitis or non-alcoholic fatty ...?
Consenting patients with suspected NAFLD (by any means) having had undergone liver biopsy as part as their routine management, simultaneously or within six months from the day of blood sampling for LIVERFAStTM test
Aged 18 to 80 years old, inclusive
Male or Female from any ethnicity
Willing to undergo blood sampling for LIVERFAStTM testing after 6 to 12 hours fasting
Willing to allow histological lecture by a pathologist for NASH-CRN and SAF scoring systems analysis of the liver biopsy
Willing and able to allow access to requested data and who were informed and signed the consent form

Exclusion Criteria

Inability to provide informed consent
Patients who may be uncooperative with the sample collection procedures
History of known Severe coagulopathy
History of known Hepatic abscess
Renal failure undergoing dialysis (GFR<45)
History of Malignancy in the past 2 years
Previous liver transplantation
Suffering with a terminal illness or any other conditions or diseases that the investigator considers inappropriate for study participation
Secondary causes of hepatic fat accumulation such as significant alcohol consumption, long-term use of a steatogenic medication, ()
Ongoing or recent significant alcohol consumption defined as >21 standard drinks on average per week in men and >14 standard drinks on average per week in women.8 Approximately 10 g of alcohol equals one 'drink' unit. One unit equals 1 ounce of distilled spirits, one 12-oz beer, or one 4-oz glass of wine
Total parenteral nutrition within 3 months of interview
Short bowel syndrome
History of gastric or jejunoileal bypass preceding the diagnosis of NAFLD. Bariatric surgery performed concomitant with or following the diagnosis of NAFLD does not exclude enrollment of patients
History of biliopancreatic diversion
Evidence of advanced liver disease defined as a Child-Pugh-Turcotte score of equal to or greater than 10
Evidence of chronic hepatitis B as marked by the presence of HBsAg in serum (patients with isolated antibody to hepatitis B core antigen, anti-HBc, are not excluded)
Evidence of chronic hepatitis C as marked by the presence of anti-HCV and HCV RNA in serum; patients with anti-HCV with PCR negative should not be excluded
Low alpha-1-antitrypsin level and ZZ phenotype (both determined at the discretion of the investigator)
History of Wilson's disease
Known glycogen storage disease
Known dysbetalipoproteinemia
Known phenotypic hemochromatosis (determined at the discretion of the investigator)
History of primary biliary cholangitis (PBC)/primary biliary sclerosis (PSC)
Hepatic vascular lesions (determined at the discretion of the investigator)
History of liver liver granulomas sarcoidosis, and infectious diseases such as tuberculosis)
Congenital hepatic fibrosis, polycystic liver disease
Other metabolic/congenital liver disease
Evidence of systemic infectious disease
Known HIV positive
Disseminated or advanced extrahepatic malignancy
Conditions that could interfere with LIVERFASt parameters and could lead to risk of false positive/ false negative results
Drug induced liver-injury (DILI), acute alcoholic hepatitis
Acute inflammatory syndrome or sepsis Active drug use or dependence that, in the opinion of the study investigator, would interfere with adherence to study requirements
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