TY - JOUR
T1 - Systematic review with meta-analysis
T2 - Diagnostic accuracy of pro-c3 for hepatic fibrosis in patients with non-alcoholic fatty liver disease
AU - Mak, Anne Linde
AU - Lee, Jenny
AU - van Dijk, Anne-Marieke
AU - Vali, Yasaman
AU - Aithal, Guruprasad P.
AU - Schattenberg, J. rn M.
AU - Anstee, Quentin M.
AU - Brosnan, M. Julia
AU - Zafarmand, Mohammad Hadi
AU - Ramsoekh, Dewkoemar
AU - Harrison, Stephen A.
AU - Nieuwdorp, Max
AU - Bossuyt, Patrick M.
AU - Holleboom, Adriaan G.
N1 - Funding Information: Conflicts of Interest: A.G.H. is supported by the Amsterdam UMC Fellowship, the Gilead Research Scholarship and grants of Health-Holland and acts as a consultant to Boehringer Ingelheim, Echosens, Gilead Sciences, Inventiva, Novo Nordisk and Norgine. J.M.S. acts as consultant or advisory board member to BMS, Boehringer Ingelheim, Echosens, Genfit, Gilead Sciences, Intercept Pharmaceuticals, Madrigal, Nordic Bioscience, Novartis, Pfizer, Roche, Sanofi, Zydus and has received research funding from Gilead Sciences. M.J.B. is an employee and share-holder of Pfizer. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. Funding Information: Funding: The results presented here are outcomes of the LITMUS project, which has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No. 777377. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - The prevalence and severity of non-alcoholic fatty liver disease (NAFLD) is increasing, yet adequately validated tests for care paths are limited and non-invasive markers of disease progression are urgently needed. The aim of this work was to summarize the performance of Pro-C3, a biomarker of active fibrogenesis, in detecting significant fibrosis (F ≥ 2), advanced fibrosis (F ≥ 3), cirrhosis (F4) and non-alcoholic steatohepatitis (NASH) in patients with NAFLD. A sensitive search of five databases was performed in July 2021. Studies reporting Pro-C3 measurements and liver histology in adults with NAFLD without co-existing liver diseases were eligible. Meta-analysis was conducted by applying a bivariate random effects model to produce summary estimates of Pro-C3 accuracy. From 35 evaluated reports, eight studies met our inclusion criteria; 1568 patients were included in our meta-analysis of significant fibrosis and 2058 in that of advanced fibrosis. The area under the summary curve was 0.81 (95% CI 0.77–0.84) in detecting significant fibrosis and 0.79 (95% CI 0.73–0.82) for advanced fibrosis. Our results support Pro-C3 as an important candidate biomarker for non-invasive assessment of liver fibrosis in NAFLD. Further direct comparisons with currently recommended non-invasive tests will demonstrate whether Pro-C3 panels can outperform these tests, and improve care paths for patients with NAFLD.
AB - The prevalence and severity of non-alcoholic fatty liver disease (NAFLD) is increasing, yet adequately validated tests for care paths are limited and non-invasive markers of disease progression are urgently needed. The aim of this work was to summarize the performance of Pro-C3, a biomarker of active fibrogenesis, in detecting significant fibrosis (F ≥ 2), advanced fibrosis (F ≥ 3), cirrhosis (F4) and non-alcoholic steatohepatitis (NASH) in patients with NAFLD. A sensitive search of five databases was performed in July 2021. Studies reporting Pro-C3 measurements and liver histology in adults with NAFLD without co-existing liver diseases were eligible. Meta-analysis was conducted by applying a bivariate random effects model to produce summary estimates of Pro-C3 accuracy. From 35 evaluated reports, eight studies met our inclusion criteria; 1568 patients were included in our meta-analysis of significant fibrosis and 2058 in that of advanced fibrosis. The area under the summary curve was 0.81 (95% CI 0.77–0.84) in detecting significant fibrosis and 0.79 (95% CI 0.73–0.82) for advanced fibrosis. Our results support Pro-C3 as an important candidate biomarker for non-invasive assessment of liver fibrosis in NAFLD. Further direct comparisons with currently recommended non-invasive tests will demonstrate whether Pro-C3 panels can outperform these tests, and improve care paths for patients with NAFLD.
KW - Biomarker
KW - Collagen type III
KW - Fatty liver
KW - Fibrosis
KW - Liver disease
KW - Pro-C3
UR - http://www.scopus.com/inward/record.url?scp=85121705029&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/biomedicines9121920
DO - https://doi.org/10.3390/biomedicines9121920
M3 - Review article
C2 - 34944736
SN - 2227-9059
VL - 9
JO - Biomedicines
JF - Biomedicines
IS - 12
M1 - 1920
ER -