81-OR: Comparison of Screening Pathways of Advanced Fibrosis Due to MASLD in Diabetology
Authors: CAUSSY CYRIELLE , VERGÈS BRUNO , LELEU DAMIEN , DUVILLARD LAURENCE , ABICHOU-KLICH AMNA , SEGRESTIN BERENICE , BIN SYLVIE , ROULAND ALEXIA , DELAUNAY DOMINIQUE , HADJADJ SAMY , PRIMOT CLAIRE , PETIT JEAN-MICHEL , CHARRIÈRE SYBIL , MOULIN PHILIPPE , LEVRERO MASSIMO , CARIOU BERTRAND , DISSE EMMANUEL 
Published: June 2024

Introduction & Objective: Screening for advanced fibrosis (AF) due to metabolic dysfunction-associated steatotic liver disease (MASLD) is recommended in patients with T2D. We have assessed the diagnostic performance of non-invasive tests (NITs) and pathways recommended by AASLD guidelines in diabetology.
Methods: Interim analysis from a multicenter prospective study including 568 patients with T2D and MASLD, age 40-80 years, BMI &lt;40 kg/m2 from 4 French diabetes clinics between Oct. 2020 and Oct. 2023. All participants had a detailed liver assessment: Fibrotest, FibroMeter, FIB-4, NFS, ELF and transient elastography (TE) by FibroScan. A low/high risk of AF was defined by a hierarchical composite criterion Fig.
Results: The characteristics were: hypertension: 71%, male 58%, mean age: 60.5 years and BMI: 32.1 kg/m2. Overall, 19% had intermediate/high risk of AF including 10% at high risk. The AUROCs of NITs for the detection of high risk AF were: NFS: 0.70, FIB-4: 0.79, Fibrometer: 0.72, Fibrotest: 0.77, ELF: 0.82. AASLD pathway using ELF classified 81.5% at low risk with 9.4% false negative (FN); 18.5% needed hepatology care with 9.1% true positive (TP). Pathway using TE classified 85.4% at low risk with 5.1% FN; 14.6% needed hepatology care with 13.3% TP (Fig).
Conclusion: Recommended AASLD pathways have a good diagnostic performance in diabetology to identify AF and the use of TE is preferable depending on availability.

Disclosure
C. Caussy: Other Relationship; Echosens, E-scopics, Novo Nordisk. Consultant; Lilly Diabetes. Other Relationship; Gilead Sciences, Inc. Consultant; GlaxoSmithKline plc, AstraZeneca, Merck Sharp & Dohme Corp. Advisory Panel; Corcept Therapeutics. B. Vergès: Consultant; Lilly Diabetes, Novo Nordisk A/S. Advisory Panel; Recordati. Consultant; AstraZeneca, Sanofi. D. Leleu: None. L. Duvillard: None. A. Abichou-Klich: None. B. Segrestin: None. S. Bin: None. A. Rouland: Other Relationship; Lilly Diabetes, Sanofi, Novo Nordisk. D. Delaunay: None. S. Hadjadj: Consultant; AstraZeneca. Research Support; Asten Santé, Air Liquide. Consultant; Bayer Inc., Boehringer-Ingelheim, Eli Lilly and Company. Research Support; LVL, Nestlé Health Science. Consultant; Novo Nordisk. Board Member; Valbiotis. Consultant; Sanofi. Research Support; Vitalaire. C. Primot: None. J. Petit: None. S. Charrière: Other Relationship; Novo Nordisk, Lilly Diabetes. Consultant; biomarin. Other Relationship; Amgen Inc., Novartis AG, Amarin Corporation. P. Moulin: Other Relationship; Novo Nordisk, Ionis Pharmaceuticals, Sanofi. Advisory Panel; ulktragenix. M. Levrero: Other Relationship; AbbVie Inc., Akero Therapeutics, Inc., Bristol-Myers Squibb Company, CSL Behring, Gilead Sciences, Inc., Inventiva Pharma, Madrigal Pharmaceuticals, Inc., Merck Sharp & Dohme Corp. Research Support; Roche Diagnostics. Advisory Panel; Roche Pharmaceuticals. B. Cariou: Speaker's Bureau; Abbott. Board Member; Air Liquide. Speaker's Bureau; Amgen Inc. Board Member; Eli Lilly and Company. Consultant; Novartis Pharmaceuticals Corporation, Novo Nordisk. Speaker's Bureau; Sanofi. Board Member; Ultragenyx. Speaker's Bureau; AstraZeneca. E. Disse: Board Member; Novo Nordisk. Consultant; Novo Nordisk, Lilly Diabetes, Sanofi, Rhythm Pharmaceuticals, Inc., Johnson & Johnson Medical Devices Companies.

Funding
IRS Grant form Gilead Inc