Evaluation of emerging NASH therapies: the impact of treatment efficacy profiles on long-term health outcomes: Supplementary materials
Aim: Evaluations of nonalcoholic steatohepatitis (NASH) treatments require predicting lifetime outcomes
from short-term clinical trials. Materials & methods: A Markov model with NASH fibrosis stages F0–
F3, NASH resolution, compensated cirrhosis (F4/CC), and liver-related complication (LRC) states was
developed using literature-based standard of care (SoC) data. Hypothetical efficacy profiles were defined
affecting resolution (100%-increase), fibrosis improvement (100% increase), or fibrosis worsening (50%
decrease). Results: For the SoC, 10-year LRC rates increased with baseline fibrosis stage (F1: 3.0%; F2:
9.8%; F3: 27.2%; F4/CC: 64.9%). The fibrosis worsening profile reduced predicted 10-year LRC rates (F1:
1.9%; F2: 6.5%; F3: 19.1%; F4/CC: 55.0%) more than the resolution and fibrosis improvement profiles
(F1: 2.6%/2.6%; F2: 8.5%/8.3%; F3: 23.3%/23.0%; F4/CC: NA/59.0%). Scenario analyses considered
alternative SoC progression, treatment efficacy and treatment-stopping rules. Conclusion: Potential NASH
efficacy profiles have differing impacts on predicted long-term outcomes, providing insights for future
stakeholders.