Neil Osterweil

November 04, 2014

BOSTON — The 2014 Liver Meeting returns to Boston, home of splendors such as beans, cod, the Boston Red Sox, world-class medical centers, and pharmaceutical research hubs.

The meeting, during which the American Association for the Study of Liver Diseases (AASLD) struts it stuff each year, will be held at the John B. Hynes Veterans Memorial Convention Center from November 7 to 11.

The Hynes, sandwiched between Boylston Street — the city's liveliest thoroughfare — and the hotels, shops, and restaurants of the Prudential Center complex, has hosted many previous Liver Meetings, and is ideally located to take advantage of the wealth of science the conference provides and all of the amenities that Boston has to offer.

Nearly 3000 abstracts were submitted by clinicians and scientists for this year's event, covering the latest clinical trial results, practice-changing clinical findings, and basic research into the mechanisms and molecular targets of diseases of the liver.

"We're going to hear a lot about fatty liver disease; the number of abstracts about fatty liver disease this year just exploded, as did the number of abstracts about complications of cirrhosis," Gary Davis, MD, AASLD secretary, told Medscape Medical News.

"This reflects what people are seeing in the clinic. The buzz for hepatitis C has died down a bit, I think because the treatment is so effective now and it's so easy to administer," he said.

Cutting Edge

That the care of patients with hepatitis C would become almost routine — or indeed that such an entity as hepatitis C ever existed — would have seemed like wild fantasy 40 years ago.

But that's just what attendees can expect to hear during the President's Choice Lecture from Willis Maddrey, MD, from the University of Texas Southwestern Medical Center at Dallas.

"Dr Maddrey is always a pretty dynamic speaker," Dr Davis said.

He pointed out that Dr Maddrey has witnessed the advent of genetic research into fatty liver disease, pegylated interferons, protease inhibitors, and other discoveries in his more than 40 years in the trenches.

Of course, with the advent of effective combination therapies for hepatitis C comes the inevitable increase in costs, just as pressures for accountability and value in medical care rise.

"There will be some presentations on cost-effectiveness, but surprisingly not a lot, given all the press it has gotten over the past year, but I want to be in the room for those. I think the discussions after the abstracts are presented will be pretty good," Dr Davis said.

On a related theme, new this year will be a symposium on value-based medicine in hepatology. The session will focus on coping in the era of Accountable Care Organizations and the Affordable Care Act. Or as the Liver Meeting program describes it, "the concept of value-based medicine and the importance of returning the practice of hepatology to its appropriate focus: enabling the health and effective care of patients with liver disease."

The $1000-per-dose therapies for hepatitis C viral infections are a challenge in this era.

The Thomas E. Starzl Transplant Surgery State-of-the-Art Lecture, by Jean Edmond, MD, from New York Presbyterian Hospital and Columbia Medical Center in New York City, will focus on the controversial topic of living-donor transplantation. Dr Edmond will outline patient and donor selection and describe the most up-to-date methods of harvesting and transplantation.

The Emerging Trends Symposium, which will follow Dr Edmond's talk, will center on a topic that might be new to some conference goers: acute on chronic liver failure. The condition is defined as acute decompensation of a patient with cirrhosis and characterized by multiple organ failure. Attendees will learn about the pathophysiology of acute liver failure, clinical issues associated with the syndrome, and investigational therapies.

The Hans Popper Basic Science State-of the-Art Lecture will be devoted to induced pluripotent stem cells and their use in the study of liver disease and development. Stephen Duncan, DPhil, from the Medical College of Wisconsin in Milwaukee, is expected to describe his groundbreaking work coaxing stem cells to differentiate into hepatocytes, Dr Davis said.

Abstract Sessions and Late-Breakers

The scientific sessions kick off on Saturday, November 8, with the first of four poster sessions covering more than 2000 research projects, from basic science findings to the latest in clinical practice, drug development, and clinical trials.

Sunday will feature transplant plenary sessions, Monday basic science and clinical plenary, and Tuesday the hepatitis plenary.

Late-breaking oral abstracts will be presented on Monday afternoon, and late-breaking posters will be on view all day Monday, with presenters available from 12:30 to 3:00 pm.

This year's late-breakers will include:

  • Results of the STOPAH trial comparing steroids with pentoxifylline for alcoholic hepatitis

  • Phase 3 results from the UNITY-2 trial of an oral fixed-dose combination therapy for patients with chronic hepatitis C genotype 1 infections and compensated cirrhosis

  • Results of the phase 3 ALLY-3 study looking at an oral ribavirin-free combination for the treatment of hepatitis C genotype 3

  • A study of post-transplant direct-acting antiviral agents for hepatitis C

  • Results from a phase 3 randomized controlled trial of an enzyme replacement therapy in children and adults with lysosomal acid lipase deficiency

  • A report on a phase 2a proof-of-concept trial of a hepatitis B and hepatitis D entry inhibitor

Ticketed educational sessions will run the gamut, from endoscopy, transplantation, pediatric hepatology, and basic research, to practical matters such as competency training and career development.

As you can still hear in some of Boston's more traditional neighborhoods, this year's Liver Meeting promises to be "wicked good."

Dr Davis have disclosed no relevant financial relationships.


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