New blood test matches gold standard for liver disease diagnosis

An experimental blood test precisely determines the extent of patients’ chronic liver disease, researchers reported on Thursday at the AASLD meeting in Denver. The test’s performance on routine blood samples matched that of magnetic resonance elastography, the most accurate non-invasive method for assessing liver disease. MRE is largely confined to specialist centers and clinical trials, however. While currently available blood tests can detect liver cancer, they cannot tell whether and to what extent patients’ livers are affected by metabolic dysfunction-associated steatohepatitis, or MASH, a condition involving inflammation and scarring that can advance to cirrhosis and liver failure. Establishing the stage of MASH today requires MRE or a liver biopsy. The new test, LiquidTransformer from Hepta, determines liver biology from DNA circulating in blood. "For years, MRE imaging has been the non-invasive benchmark we rely on in our research. It’s the most accurate way we have to stage liver fibrosis without a biopsy,” Dr. Rohit Loomba, of UC San Diego, Hepta's chief medical and scientific adviser, said in a statement. Working with Hepta and Madrigal Pharmaceuticals, which sells Rezdiffra, the first approved MASH therapy, researchers showed the test accurately staged patients’ liver damage and identified those who were eligible for the drug. In other experiments, the technology also distinguished between the three forms of steatotic liver disease: MASLD, driven by metabolic dysfunction; ALD, driven by alcohol; and MetALD, where the two coexist. In patients receiving the GLP-1 drug semaglutide, LiquidTransformer detected molecular changes attributable to the drug. Semaglutide - sold by Novo Nordisk as Wegovy for weight loss and Ozempic for diabetes - is known to provide liver benefits and has been approved in the US to treat MASH. Whether the drug has independent effects on the liver unrelated to weight loss has not been established. Overall, in six separate AASLD presentations, LiquidTransformer was reported to be nearly as accurate as MRE and even more accurate than second-line alternatives, such as an ultrasound method known as vibration-controlled transient elastography and another blood test called the enhanced liver fibrosis test. "Seeing a blood test approach the diagnostic accuracy of MRE and beat (other alternatives) at determining treatment eligibility is a real step forward, as that is an important unmet need given the wider availability and access of a blood test," Loomba said.