Study Highlights Real-World Mortality Rates, Factors Increasing Mortality Risk in MASH

An analysis of real-world data more than 18,000 US patients with metabolic dysfunction-associated steatohepatitis (MASH) is shedding light on mortality rates, causes of death and impact of biomarkers and socioeconomic factors on mortality rates among this patient population.

Presented during the 22nd Annual World Congress Insulin Resistance Diabetes & Cardiovascular Disease (WCIRDC), data from the study provide valuable insight into factors influencing risk of mortality among these patients.1

“In MASH patients, mortality risks were higher in presence of metabolic risk factors, including kidney disease. Regional differences also impacted MASH mortality rates,” wrote investigators.1

With 2024 welcoming approvals for resmetirom as well as positive phase 2 and phase 3 trials, healthcare providers are eager to welcome a new era in management of MASH. Just as the therapeutic pipeline for MASH has begun to bear fruit, the medical community has begun to recognize and investigate MASH, obesity, and other chronic illnesses as part of a spectrum of metabolic disease.2,3

Supported and funded by Boehringer Ingelheim, the current study was designed by Jörn M. Schattenberg, MD, professor of medicine and director of the department of Internal Medicine at Saarland University Hospital, to evaluate trends in mortality rates, causes of death, and the role of socioeconomic risk factors in mortality risk among patients with MASH using deidentified data recorded from 2016 to 2021 within the Optum Market Clarity linked claims database. Of note, the investigators identified MASH patients using the ICD-10 diagnosis code K75.81 for nonalcoholic steatohepatitis.1

Outcomes of interest for the analysis included associations between risk factors of disease progression, such as age, region, and biomarkers, and mortality. For the purpose of analysis, investigators calculated crude and stratified mortality incidence rates among MASH patients based on presence of elevated body mass index (BMI) and type 2 diabetes.1

A total of 18,710 MASH patients with a mean follow-up of 6.5 years were identified for incision in the study. Among this group, 1465 patient deaths occurred during the follow-up period. Of these, 70% were attributed to cardiovascular disease and 17% were attributed to liver-related causes.1

Results of the investigators’ analyses indicated having an eGFR of less than 60mL/min/1.73m2 (Hazard ratio [HR], 3.01) and having 3 or more metabolic comorbidities (HR, 1.93) were associated with increased mortality. Investigators also highlighted findings pointing to an increased rate of all-cause mortality among those living in the Southern United States relative to their counterparts in the Northeast (HR, 1.56).1

Results of secondary analyses offered evidence suggesting MASH patients with a BMI of 25 kg/m2 or greater and type 2 diabetes had a mortality rate of 31 per 1000 patient-years, which investigators noted was 5 times greater than the rate observed among those with a BMI of 25 kg/m2 or greater but without liver disease and type 2 diabetes.1

“Incident mortality was higher in patients living with overweight/obesity and MASH vs overweight/obesity without MASH, but further analysis is needed to take confounding factors into account,” investigators noted.1

References:

1. Schattenberg JM, Martini C, Herrera R, Raluy M, Yates M, Younes R. Causes of Death, Mortality Rates, and the Role of Socio-demographic Risk Factors and Biomarkers in Metabolic Dysfunction-associated Steatohepatitis Mortality in More than 18,000 Real World Patients from the United States. Presented at the 22nd Annual World Congress Insulin Resistance Diabetes & Cardiovascular Disease (WCIRDC). Los Angeles, California. December 12-14, 2024.
2. Brooks A. Resmetirom (Rezdiffra) receives historic FDA approval for noncirrhotic Nash. HCP Live. March 14, 2024. Accessed December 15, 2024. https://www.hcplive.com/view/resmetirom-rezdiffra-receives-historic-fda-approval-for-noncirrhotic-nash.
3. Brooks A. FDA grants breakthrough therapy designation to Survodutide for Noncirrhotic Mash. HCP Live. October 8, 2024. Accessed December 15, 2024. https://www.hcplive.com/view/fda-grants-breakthrough-therapy-designation-survodutide-noncirrhotic-mash.