OBJECTIVES: Non-alcoholic steatohepatitis (NASH) is a chronic liver disease with severe complications and no approved therapies. We conducted an online survey to determine patient perceptions around their liver condition, and their preference regarding attributes for potential treatments in NASH.

METHODS: The Patient Preference study with NASH patients in fibrosis stages F2 or F3 from the USA, Canada, Germany and the UK was conducted between November 2017 and May 2018. Adaptive choice-based conjoint (ACBC) methodology was used for hypothetical product profiles in order to identify patient preferences. ACBC is a two-step process: First, identifying the most important treatment-related attributes for patients which represented the basis for the hypothetical treatment profiles. Second, the selection of these hypothetical product profiles is tested through trade-off exercises in which patients choose their preferred treatment options. All results are based on patient-reported data.

RESULTS: A total of 151 patients completed the survey (USA: 50, Germany: 48, Canada: 36, UK: 17). Based on relative importance of attributes for potential hypothetical treatments, the beneficial effect on patients’ liver status – e.g. regression of fibrosis from F3 to F2 or F1 and reduction of inflammation (relative importance: 29% [range, 14%-39%]) had highest impact on treatment choice followed by symptoms linked with liver disease (14% [range, 11%-20%]). Impact on weight (13% [7%-22%]), blood sugar and cholesterol (13% [11%-20%]) and progression to cirrhosis (13% [8%-16%]) had more weightage than select treatment-related side effects (diarrhea: 5% [0-9%], nausea: 4% [0-8%], itching: 1% [1%-9%], headache: 1% [0-3%]).

CONCLUSIONS: Patients considered efficacy on liver status (“my liver is better based on test results”) as the most important attribute, irrespective of impact on other attributes. Among treatments with similar efficacy, benefits such as prevention of progression to cirrhosis, effect on weight loss, symptoms and better safety, were also constituted as value.