iiinova — where your digital self keeps evolving

Peter Jepsen @peterjepsen.bsky.social · 08/05/2025

Congratulations, Mattias! Your recognition is hugely deserved. Keep up the excellent work!

Peter Jepsen @peterjepsen.bsky.social · 10/04/2025

I haven't been able to find NICE guidance about this question, but BSG guidelines do recommend biopsy "if systemic treatment is being considered". www.bsg.org.uk/getmedia/076...

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Peter Jepsen @peterjepsen.bsky.social · 09/04/2025

EASL guidelines: “In patients with cirrhosis, HBV infection or a previous diagnosis of HCC, a liver nodule can be diagnosed non-invasively as HCC when major features are observed with dynamic contrast-enhanced CT, MRI or ultrasound (CEUS)”.

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Peter Jepsen @peterjepsen.bsky.social · 09/04/2025

These are ESMO guidelines, not EASL. The justification is that it’s important to have the correct diagnosis. I am paraphrasing, but that IS the justification.

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Peter Jepsen @peterjepsen.bsky.social · 03/04/2025

Here is an update on the cirrhosis epidemiology in Denmark: doi.org/10.1016/j.jh... * Median age at cirrhosis diagnosis up from 56y in 1998 to 66y in 2022 * Proportion with ALD cirrhosis down from 80% to 58% * Prevalence of cirrhosis peaked in 2024 * Survival has improved #Liversky

doi.org

Redirecting

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Peter Jepsen @peterjepsen.bsky.social · 14/03/2025

As if this area wasn't difficult enough already... I'm sure it will be a hot topic for discussion among the good people of ISHEN at the Montreal meeting in October. ishen.org/ishen-2025/

ishen.org

ISHEN 2025 | ISHEN

ISHEN2025 at St-Alexis-des-Monts, Canada : the only international meeting dedicated to hepatic encephalopathy.

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Peter Jepsen @peterjepsen.bsky.social · 11/03/2025

Validation studies are important, yes!

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Peter Jepsen @peterjepsen.bsky.social · 03/03/2025

We typically begin at 40mg prednisolone and taper fast at first (till we reach 15mg, say), then more slowly as azathioprine kicks in. We still use azathioprine rather than MMF.

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Peter Jepsen @peterjepsen.bsky.social · 21/02/2025

For those who - like me - wondered what the figure shows, it's "Lifetime alcohol use in 15-year-olds by country (top 10)". I had hoped it was "adolescent sobriety", but unfortunately it wasn't... We Danes take comfort in knowing that our alcohol consumption is declining and has been for many years.

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Peter Jepsen @peterjepsen.bsky.social · 20/02/2025

Well done, Merle and Hannes. Yes, we definitely need to know more about the logistics and expected outcomes of fibrosis screening for patients, GPs, and hospitals.

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Peter Jepsen @peterjepsen.bsky.social · 16/02/2025

Congratulations! Well done. The risk of HCC seemed to be higher for those with MASLD cirrhosis, but I assume that's because of their older age and higher proportion of men.

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Peter Jepsen @peterjepsen.bsky.social · 16/02/2025

I have followed Vinay for many years, and I used to like his podcast. That ended during Covid. It seems that science became heavily politicized then and still is. His book “Ending medical reversal” is good and has instructive examples of science being wrong (despite good intentions). No rants then…

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Peter Jepsen @peterjepsen.bsky.social · 14/02/2025

JHEP Reports has published our update cirrhosis epidemiology in Denmark: www.sciencedirect.com/science/arti... Our population of cirrhosis patients is changing: They're older now than they used to be, and fewer have ALD. The incidence of ALD is decreasing in Denmark, unlike in so many other places.

sciencedirect.com

Cirrhosis epidemiology in Denmark 1998–2022 and 2030 forecast

Cirrhosis incidence due to alcohol-related liver disease (ALD) is decreasing in Denmark, while the obesity incidence is increasing, expectably driving…

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Reposted by Peter Jepsen

Elliot Tapper @ebtapper.bsky.social · 06/02/2025

BREAKING: rifaximin and simvastatin did not help people with decompensated cirrhosis Congratulations to Elisa Pose And congrats to @jama.com for getting this paper #liversky t.co/BuPL0mURhl

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Peter Jepsen @peterjepsen.bsky.social · 07/01/2025

This is a figure of age-specific incidence rates of alcohol-related liver disease in Denmark, by birth cohort. It shows that generations born after 1960 have had lower age-specific incidence rates than earlier generations (so far, at least). This is from pubmed.ncbi.nlm.nih.gov/33442297/ (OA.)

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EASL @easlnews.bsky.social · 03/01/2025

👋Hello #Liversky! 🗞️Proud to see our EASL experts @debbieshawcross.bsky.social , @ahmedelsharkawy.bsky.social, and Philip Newsome featured in The Guardian with advice on liver health. Indulged during the holidays? It's not too late to give your liver some love!💚 www.theguardian.com/lifeandstyle...

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Peter Jepsen @peterjepsen.bsky.social · 03/01/2025

I suspect the analysis includes prevalent cancers, i.e., those that are diagnosed within a few months after PSC diagnosis. They are important, too, of course, but may inflate the incidence rate (which is more relevant for decisions about cancer surveillance during follow-up).

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Tom Calver @tomcalver.bsky.social · 29/12/2024

NEW: Is the NHS still good value for money? Billions of pounds are being ploughed into Britain’s health service — with little noticeable improvement in health since 2019. Critics say the NHS has become bloated and inefficient. Is it? @thetimes.com 🔗 www.thetimes.com/article/1130... 1/7

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Atoosa Rabiee @atoosarabiee.bsky.social · 17/12/2024

Updated HCC management guidelines by @easlnews.bsky.social Must read 👇🏼👇🏼👇🏼 www.journal-of-hepatology.eu/article/S016... #Liversky

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Gastroenterology @gastroenterology.bsky.social · 19/12/2024

#LiverSky: Updated advice for management of HCC! EASL Clinical Practice Guidelines 🔗 www.journal-of-hepatology.eu/article/S016...

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Rob Brierley @robbrierley.bsky.social · 17/12/2024

New Review - The liver–brain axis in metabolic dysfunction-associated steatotic liver disease www.thelancet.com/journals/lan...

Cognitive functions that might be affected in patients with MASLD

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Colin Angus @victimofmaths.bsky.social · 27/11/2024

The Medical Council on Alcohol have just launched a new report calling for a new strategy for the health care response to rising levels of alcohol-related harm in the UK. Lots of sensible ideas here, especially around integrated alcohol and mental health care. m-c-a.org.uk/policy/

m-c-a.org.uk

Policy - Medical Council on Alcohol

The Medical Council on Alcohol is not primarily a campaigning organisation but we do support other organisations active in the public health and policy spheres to reduce alcohol-related harm. The MC...

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Colin Angus @victimofmaths.bsky.social · 02/12/2024

Here's my version of a graph originally by the British Liver Trust showing how rates of liver disease deaths in England & Wales have almost quadrupled since 1968, while other leading causes of death have fallen. In spite of working in alcohol research for 13+ years, this still surprised me...

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Peter Jepsen @peterjepsen.bsky.social · 25/11/2024

Thanks! I think we - as a field - sometimes create problems for ourselves by describing compensated cirrhosis as "asymptomatic".

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Andrew Moon @andrewmmoon.bsky.social · 17/11/2024

In the United States, HCC deaths may have plateaued and soon be on the decline due to successful HCV elimination However, persistent increases in MASLD and ALD-related HCC threaten these trends AASLD #TLM24 #Liversky

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Peter Jepsen @peterjepsen.bsky.social · 16/11/2024

More information about the belittling of compensated cirrhosis in the Global Burden of Disease studies here: www.journal-of-hepatology.eu/article/S016...

journal-of-hepatology.eu

DEFINE_ME

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Peter Jepsen @peterjepsen.bsky.social · 16/11/2024

Interesting! The Global Burden of Disease studies assign a disability weight of ZERO to compensated cirrhosis, meaning that compensated cirrhosis is not considered a source of morbidity. Downstream consequence: Cirrhosis is overlooked in healthcare systems where chronic diseases fight for attention.

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