P1822 - Evaluation of the FAST Score as a Predictor of Fibrotic NASH in Hispanics

Prido Polanco, MD¹, Rashme Patil, MD², Mario D'gyves, ¹, Phuc Le, PhD, MPH³, Radha Mantena, MD¹, Vinyas Bhat, ¹, Yash Chatha, ¹, Sahil Choudhri, ¹, Pranay Garg, ¹, Nikhil Kahlon, ¹, Shrika Kantala, ¹, Anita Kohli, MD¹, Mazen Noureddin, MD, MHSc⁴, Stephen A. Harrison, MD⁵, Naim Alkhouri, MD^1
1Arizona Liver Health, Chandler, AZ; ²South Texas Research Institute, Edinburg, TX; ³Cleveland Clinic, Cleveland, OH; ⁴Fatty Liver Program at Cedars-Sinai, Los Angeles, CA; ⁵Pinnacle Clinical Research, San Antonio, TX

Introduction: Background: The Fibroscan-AST (FAST) score was developed to predict the presence of “at risk” NASH (NAFLD activity score (NAS) ≥4 and Fibrosis ≥2) using liver stiffness measurement (LSM) as assessed by Fibroscan™, controlled attenuated parameter (CAP) and AST. Limited data exist on the using the FAST score in Hispanics who are at higher risk for fibrotic NASH. Therefore, the aim of this study was to evaluate the performance of the FAST score against liver biopsy in a cohort of Hispanics.

Methods: Consecutive patients with suspected NAFLD who had liver biopsy and LSM/ AST performed within a 6-month period were included. NASH, NAS, and fibrosis stage were assessed using the NASH CRN criteria. M and XL probes were chosen based on the automated machine recommendation. Patients were excluded if they had > 5% change in body weight. C statistics were used to assess FAST accuracy and sensitivity, specificity, NPV, and PPV were calculated.

Results: 245 patients were included with mean age of 57 years, mean BMI of 34.5 (± 4.8) kg/m2, mean HbA1C of 6.2%, 50% had type 2 diabetes. Fibrotic NASH on liver biopsy was present in 25% of patients. The FAST score had good overall accuracy in predicting “at risk” NASH with AUC of 0.75 (95% CI: 0.68 – 0.82). At the low cutoff value (< 0.35) corresponding to 90% sensitivity (rule out zone), the FAST had a good NPV of 89%. However, at the high cutoff value ( >0.67) corresponding to 90% specificity (rule in zone), the FAST score had low PPV of 48.3%. 117 patients were in the rule out zone, 62 were in the rule in zone, and 66 were classified as indeterminate.

Discussion: Conclusion: The FAST score performed well to exclude the presence of “at risk” NASH in Hispanics. The FAST score had low PPV and was less accurate in making a positive diagnosis of “at risk” NASH in the Hispanic population. These findings may have implications on how to optimize the use of this score in this high-risk population for both inclusion in NASH therapeutic trials and for selecting patients for pharmacologic treatment.


Disclosures:
Prido Polanco indicated no relevant financial relationships.
Rashme Patil indicated no relevant financial relationships.
Mario D''gyves indicated no relevant financial relationships.
Phuc Le indicated no relevant financial relationships.
Radha Mantena indicated no relevant financial relationships.
Vinyas Bhat indicated no relevant financial relationships.
Yash Chatha indicated no relevant financial relationships.
Sahil Choudhri indicated no relevant financial relationships.
Pranay Garg indicated no relevant financial relationships.
Nikhil Kahlon indicated no relevant financial relationships.
Shrika Kantala indicated no relevant financial relationships.
Anita Kohli indicated no relevant financial relationships.
Mazen Noureddin: Echosens – Advisory Committee/Board Member.
Stephen Harrison: Echosens – Advisory Committee/Board Member.
Naim Alkhouri: Echosens – Advisory Committee/Board Member.


Prido Polanco, MD¹, Rashme Patil, MD², Mario D'gyves, ¹, Phuc Le, PhD, MPH³, Radha Mantena, MD¹, Vinyas Bhat, ¹, Yash Chatha, ¹, Sahil Choudhri, ¹, Pranay Garg, ¹, Nikhil Kahlon, ¹, Shrika Kantala, ¹, Anita Kohli, MD¹, Mazen Noureddin, MD, MHSc⁴, Stephen A. Harrison, MD⁵, Naim Alkhouri, MD¹. P1822 - Evaluation of the FAST Score as a Predictor of Fibrotic NASH in Hispanics, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.