Clinique NASH, an innovative care pathway unique in France

The NASH clinic was set up in 2019 by a multidisciplinary team from the AP-HP with the support of the IHU-ICAN in order to optimize the diagnosis and management of people with fatty liver disease; better control their disease and slow down or even curb its progression towards serious forms (cirrhosis, liver cancer) requiring major interventions such as liver transplantation.

NASH (Non-Alcoholic Fatty Liver Disease) is aliver disease caused by an accumulation of fat of metabolic origin independent of alcohol consumption or viral hepatitis. It is very often the consequence of a lifestyle that is too sedentary associated with a diet that is too rich in fats and sugars.

It concerns between 400,000 and 500,000 people in France per year, i.e. 25% of the general adult population . People with NASH are often asymptomatic and have a higher risk of developing cardiovascular disease, high blood pressure, or diabetes. Conversely, these comorbidities, particularly obesity and diabetes, are risk factors for the progression of liver damage to the most severe forms (cirrhosis and liver cancer).

The NASH clinic: the first hospital structure for the multidisciplinary care of patients with metabolic steatosis in France

Also, the AP-HP and ICAN teams have created the NASH clinic to offer patients a care pathway innovative, multidisciplinary and personalized. This course aims toanticipate and intercept the complications of NASH (early atherosclerosis, arterial hypertension, diabetes, etc.) and offer personalized care to each patient, taking into account their clinical phenotype, personal history and environment to ensure the best possible compliance with medical recommendations. The IHU-ICAN has made available dedicated human resources (1 doctor and 1 nurse) as well as its clinical investigation center, and has offered the conditions necessary for the construction of this course thanks to its transversal and multidisciplinary approach to diseases. cardiometabolism and nutrition.

Today, more than 200 patients have already benefited from it. The patient journey is simplified and unified within the framework of day hospitalization in the hepato-gastroenterology and nutrition departments of the Pitié-Salpêtrière hospital. Various medical specialists (hepatologist, radiologist, cardiologist, dietitian, diabetologist, surgeon, etc.) are mobilized to carry out the examinations necessary to establish a phenotype and a precise diagnosis with an assessment of hepatic and cardiometabolic risk. For better patient support, the circuit also offers a therapeutic education consultation, essential for better adherence to the proposed therapeutic programs.