MASLD Prevalence Predicted to Surge in the US

TOPLINE:

Two in 5 US adults (approximately 122 million) will have metabolic dysfunction–associated steatotic liver disease (MASLD) by 2050, with a concurrent increase in liver cancer, cirrhosis, and need for liver transplant.

METHODOLOGY:

• Researchers performed a decision analytical modeling study, incorporating a microsimulation approach and the most up-to-date data on disease progression, to estimate the clinical burden of MASLD and liver-related complications in the United States between 2020 and 2050.
• The model simulated approximately 2.82 million adults aged ≥ 18 years (mean age, 35.8 years; 50.9% female).
• Data inputs were derived from US-based epidemiological studies, including the National Health and Nutrition Examination Survey.
• Annual health transitions (from fibrosis to advanced liver disease) were modeled based on predefined probabilities. The model accounted for individual-level variations in disease progression and was calibrated using mortality, fibrosis, and transplant data.

TAKEAWAY:

• MASLD prevalence was predicted to increase from 86.3 million (33.7% of US adults) in 2020 to 121.9 million (41.4%) by 2050.
• Cases of metabolic dysfunction–associated steatohepatitis (MASH) are expected to increase from 14.9 million (5.8%) in 2020 to 23.2 million (7.9%) by 2050.
• Cases of MASH with clinically significant fibrosis (F stage of ≥ F2, centrilobular and periportal fibrosis, or more severe disease) are predicted to increase from 6.7 million in 2020 to 11.7 million by 2050.
• New cases of hepatocellular carcinoma are projected to double from 11,483 new cases per year in 2020-2025 to 22,440 annually by 2046-2050, and liver transplants are projected to quadruple from 1717 to 6720 annually during the same period.
• Annual liver-related deaths will triple from 30,500 in 2020 (1.0% of all-case deaths in adults) to 95,300 (2.4%) by 2050.

IN PRACTICE:

“In the absence of effective treatments, health systems should plan for large increases in liver cancer and transplant,” the authors wrote. “By implementing preventive strategies, investing in research, and preparing healthcare systems, we can minimize the impact of MASLD and improve the lives of millions of individuals affected by this disease.”

SOURCE:

This study, with first author Phuc Le, PhD, MPH, from the Center for Value-Based Care Research, Cleveland Clinic, Cleveland, was published online in JAMA Network Open.

LIMITATIONS:

The model focused on the natural progression of disease and did not account for potential future advancements in treatment or preventive strategies, which could alter projections. The model was based on observational data, which may be incomplete, inaccurate, or introduce bias.

DISCLOSURES:

This study was funded by the Agency for Healthcare Research and Quality. Several authors reported receiving grants and personal fees from academic institutions, pharmaceutical companies, and private companies.