NASH Clinic
NASH Clinic
An innovative treatment journey 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 a liver 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. The risk is an evolution towards serious illnesses such as cirrhosis or liver cancer.
In France, 18% of the general adult population are affected. 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 multiplicity of pathologies associated with NASH too often leads to a fragmentation of medical care, without coordination between the multiple stakeholders.
Improving the diagnosis among the many subjects at risk for earlier management in order to avoid the progression of the disease and the development of other pathologies are public health issues. There is also an economic issue because the cost of taking charge of this pathology weighs on the social security budget.
Also, the AP-HP and ICAN teams created the NASH clinic to offer patients an innovative, multidisciplinary and personalized care pathway. This course aims to anticipate and intercept the complications of NASH (early atherosclerosis, arterial hypertension, diabetes, etc.) and to offer personalized care to each patient by taking into account their clinical phenotype, their personal history and their 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 of the cardiometabolism and nutrition.
The NASH clinic is the first hospital structure for the diagnosis and multidisciplinary management of patients with metabolic steatosis in France. 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.
The advantages of the NASH clinic
- Multidisciplinarity and transversality
- Unified and fluid circuit
- Personalized support
- Dedicated human resources
- Integration of care and research
Dr. Raluca Pais
Hepatologist/Gastroenterologist - referring physician for the NASH clinic
” Patients perform in a single day all the examinations essential to the diagnosis of their pathology and to assess their personal risk of progression to more serious forms or of developing other pathologies: liver exploration to assess the severity of liver damage , cardiovascular exploration – coronary calcium score to identify early atherosclerotic lesions; metabolic exploration to assess the risk of developing type 2 diabetes and metabolic comorbidities.»
Professor Vlad Ratziu
Hepatologist/Gastroenterologist
” To counter the development of NASH in the French population and reduce the number of hospitalizations due to NASH, it is essential that the patient take the measure of the risk of progression of his disease and the associated comorbidities in order to modify his lifestyle . »
