LIVERFASt for assessing and monitoring liver fibrosis, activity and steatosis

The technology described in this briefing is LIVERFASt. It is used for detecting and staging liver fibrosis, activity and steatosis in people with non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), hepatitis B and hepatitis C.

The innovative aspects are that LIVERFASt may simplify diagnosing and monitoring liver disease and damage. It may improve disease management and understanding of disease progression.

The intended place in therapy would be as an alternative to existing non- or minimally invasive tests and liver biopsy, to detect and monitor fibrosis and cirrhosis in people with suspected or diagnosed liver disease.

The main points from the evidence summarised in this briefing are from 6 studies (5 prospective cohort studies and 1 retrospective study) including a total of 3,144 people with liver disease. They show that LIVERFASt performs as well as transient elastography in detecting liver disease. It may also improve detection of severe disease when used with other tests.

Key uncertainties around the evidence or technology are that 5 of the 6 reviewed studies were reported only as abstracts with limited details on study methods, patient demographics and discussion of findings.

Experts advised that LIVERFASt may be used as a second-line tool or in combination with existing tests to improve diagnostic accuracy; however, its place in the NHS pathway was not clear and this would determine patient and system benefits. All experts advised that more evidence is needed on the use of LIVERFASt in the NHS.

The cost of LIVERFASt is £55 per test (excluding VAT). The average cost of non- or minimally invasive tests in standard care ranges from £6 to £136. Costs of liver biopsy range from £358 (outpatient percutaneous liver biopsy) to £1,160 (outpatient transvenous liver biopsy).