Peter Jepsen

Congratulations, Mattias! Your recognition is hugely deserved. Keep up the excellent work!

I haven't been able to find NICE guidance about this question, but BSG guidelines do recommend biopsy "if systemic treatment is being considered".
www.bsg.org.uk/getmedia/076...

EASL guidelines: “In patients with cirrhosis, HBV infection or a previous diagnosis of HCC, a liver nodule can be diagnosed non-invasively as HCC when major features are observed with dynamic contrast-enhanced CT, MRI or ultrasound (CEUS)”.

These are ESMO guidelines, not EASL. The justification is that it’s important to have the correct diagnosis. I am paraphrasing, but that IS the justification.

Here is an update on the cirrhosis epidemiology in Denmark: doi.org/10.1016/j.jh...
* Median age at cirrhosis diagnosis up from 56y in 1998 to 66y in 2022
* Proportion with ALD cirrhosis down from 80% to 58%
* Prevalence of cirrhosis peaked in 2024
* Survival has improved
#Liversky

Congratulations! Well done.

As if this area wasn't difficult enough already... I'm sure it will be a hot topic for discussion among the good people of ISHEN at the Montreal meeting in October. ishen.org/ishen-2025/

Validation studies are important, yes!

We typically begin at 40mg prednisolone and taper fast at first (till we reach 15mg, say), then more slowly as azathioprine kicks in. We still use azathioprine rather than MMF.

For those who - like me - wondered what the figure shows, it's "Lifetime alcohol use in 15-year-olds by country (top 10)". I had hoped it was "adolescent sobriety", but unfortunately it wasn't... We Danes take comfort in knowing that our alcohol consumption is declining and has been for many years.

Well done, Merle and Hannes. Yes, we definitely need to know more about the logistics and expected outcomes of fibrosis screening for patients, GPs, and hospitals.

Congratulations! Well done. The risk of HCC seemed to be higher for those with MASLD cirrhosis, but I assume that's because of their older age and higher proportion of men.

I have followed Vinay for many years, and I used to like his podcast. That ended during Covid. It seems that science became heavily politicized then and still is. His book “Ending medical reversal” is good and has instructive examples of science being wrong (despite good intentions). No rants then…

Cirrhosis epidemiology in Denmark 1998–2022 and 2030 forecast Cirrhosis incidence due to alcohol-related liver disease (ALD) is decreasing in Denmark, while the obesity incidence is increasing, expectably driving…

JHEP Reports has published our update cirrhosis epidemiology in Denmark: www.sciencedirect.com/science/arti...
Our population of cirrhosis patients is changing: They're older now than they used to be, and fewer have ALD. The incidence of ALD is decreasing in Denmark, unlike in so many other places.

BREAKING: rifaximin and simvastatin did not help people with decompensated cirrhosis

Congratulations to Elisa Pose
And congrats to @jama.com for getting this paper
#liversky t.co/BuPL0mURhl

This is a figure of age-specific incidence rates of alcohol-related liver disease in Denmark, by birth cohort. It shows that generations born after 1960 have had lower age-specific incidence rates than earlier generations (so far, at least). This is from pubmed.ncbi.nlm.nih.gov/33442297/ (OA.)

👋Hello #Liversky!
🗞️Proud to see our EASL experts @debbieshawcross.bsky.social , @ahmedelsharkawy.bsky.social, and Philip Newsome featured in The Guardian with advice on liver health.
Indulged during the holidays? It's not too late to give your liver some love!💚
www.theguardian.com/lifeandstyle...

I suspect the analysis includes prevalent cancers, i.e., those that are diagnosed within a few months after PSC diagnosis. They are important, too, of course, but may inflate the incidence rate (which is more relevant for decisions about cancer surveillance during follow-up).

Love your liver! 19 simple ways to look after this incredible organ, chosen by doctors Should you do Dry January? Is any amount of alcohol good for you? And do detoxes work? Experts reveal the tips they live by Whether or not you have overdone it during the festivities, it is never too late to give your liver some love. Here, doctors share…

Love your liver! 19 simple ways to look after this incredible organ, chosen by doctors

NEW: Is the NHS still good value for money?

Billions of pounds are being ploughed into Britain’s health service — with little noticeable improvement in health since 2019.

Critics say the NHS has become bloated and inefficient. Is it?

@thetimes.com

🔗 www.thetimes.com/article/1130...

1/7

Updated HCC management guidelines by @easlnews.bsky.social

Must read 👇🏼👇🏼👇🏼

www.journal-of-hepatology.eu/article/S016...

#Liversky

#LiverSky: Updated advice for management of HCC!

EASL Clinical Practice Guidelines

🔗 www.journal-of-hepatology.eu/article/S016...

Cognitive functions that might be affected in patients with MASLD

New Review - The liver–brain axis in metabolic dysfunction-associated steatotic liver disease

www.thelancet.com/journals/lan...

Policy - Medical Council on Alcohol The Medical Council on Alcohol is not primarily a campaigning organisation but we do support other organisations active in the public health and policy spheres to reduce alcohol-related harm. The MC...

The Medical Council on Alcohol have just launched a new report calling for a new strategy for the health care response to rising levels of alcohol-related harm in the UK.

Lots of sensible ideas here, especially around integrated alcohol and mental health care.

m-c-a.org.uk/policy/

Here's my version of a graph originally by the British Liver Trust showing how rates of liver disease deaths in England & Wales have almost quadrupled since 1968, while other leading causes of death have fallen.

In spite of working in alcohol research for 13+ years, this still surprised me...

Thanks! I think we - as a field - sometimes create problems for ourselves by describing compensated cirrhosis as "asymptomatic".

Raising the Bar: Is Hepatocellular Carcinoma Surveillance Warranted for Patients With Alcohol-Associated Cirrhosis? - PubMed Raising the Bar: Is Hepatocellular Carcinoma Surveillance Warranted for Patients With Alcohol-Associated Cirrhosis?

Thank you for this thoughtful editorial, @andrewmmoon.bsky.social
pubmed.ncbi.nlm.nih.gov/39445687/

In the United States, HCC deaths may have plateaued and soon be on the decline due to successful HCV elimination

However, persistent increases in MASLD and ALD-related HCC threaten these trends

AASLD #TLM24 #Liversky

More information about the belittling of compensated cirrhosis in the Global Burden of Disease studies here: www.journal-of-hepatology.eu/article/S016...

Interesting! The Global Burden of Disease studies assign a disability weight of ZERO to compensated cirrhosis, meaning that compensated cirrhosis is not considered a source of morbidity. Downstream consequence: Cirrhosis is overlooked in healthcare systems where chronic diseases fight for attention.