Health-care burden of metabolic dysfunction-associated steatotic liver disease in European tertiary-care outpatient clinics (CONSTANS): a prospective multicentre cohort study.
13 affiliations
- 1Sorbonne Université, Paris, France.
- 2ICAN Institute for Cardiometabolism and Nutrition, Paris, France.
- 3Assistance Publique-Hôpitaux de Paris, Hepatogastroenterology Department, Pitié-Salpêtrière Hospital, Paris, France.
- 4INSERM UMRS 1138 CRC, Paris, France.
- 5Inselspital, Universitätsspital Bern, Bern, Switzerland.
- 6Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
- 7Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
- 8Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
- 92nd Department of Internal Medicine, PJ Safarik University, Faculty of Medicine and L Pasteur University Hospital, 04011, Kosice, Slovakia.
- 10Department of Internal Medicine, Hospital Poprad, Slovakia.
- 11Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Sevilla, Spain.
- 12Newcastle NIHR Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK.
- 13Department of Medicine, University Medical Centre Mainz, Germany.
Abstract
Despite modeling-based epidemiological studies of MASLD, precise estimates of the prevalence and health-care resource utilization in outpatient clinical practice are unknown. We assessed, in a real-life setting, the prevalence of suspected/confirmed MASLD and described health-care resource utilization. A prospective, observational study of patients attending the outpatient hepato-gastroenterology clinics of eight European tertiary care centers during three months. Follow-up data of patients with suspected/confirmed MASLD were recorded 12 months after the screening visit: final diagnosis, disease stage, diagnostic work-up and the use of health-care resources. 5240 outpatients from Germany, France, United Kingdom, Switzerland, Italy, Spain and Slovakia were screened. The main reasons for visit were: chronic viral hepatitis, 33.4% (1749/5240), miscellaneous hepatobiliary conditions including neoplasms, 32.9% (1725/5240) and known/suspected MASLD, 24.7% (1293/5240) (pooled prevalence of 26.1% (95% CI: 19.1-34.7)). 1134 suspected/confirmed MASLD patients were included, the diagnosis was confirmed in 80.2% (909/1134). Significant fibrosis was documented in 22.7% (257/1134) and cirrhosis (including burn-out MASLD) in 21.3% (241/1134). Procedures performed differed between countries, overall 66.4% (753/1134) had imaging studies, 65.3% (740/1134) non-invasive fibrosis tests, 20.4% (231/1134) liver biopsy, while referral for further cardiometabolic assessment or therapy was minimal (144/1134, 15.8%). The cost of all procedures and visits was in the range of that recommended for exploring hepatitis C before treatment, although highly variable between countries. MASLD was the second most frequent single cause for outpatient visits in eight European tertiary care centers. Significant fibrosis including cirrhosis was diagnosed in 44% of patients. The cost of required additional visits and procedures was equivalent to that recommended for hepatitis C before antiviral treatment. IMI2-Grant Agreement 777377-LITMUS.
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BibTeX
@article{ratziu2026healthcare,
title = {{Health-care burden of metabolic dysfunction-associated steatotic liver disease in European tertiary-care outpatient clinics (CONSTANS): a prospective multicentre cohort study.}},
author = {Vlad Ratziu and Jean-François Dufour and Maharajah Ponnaiah and Raluca Pais and Maximilian Thormann and Elisabetta Bugianesi and Fabio Marra and Marie Boyle and Kate Hallsworth and Silvia Aspite and Sylvia Drazilova and Federico Ravaioli and Manuel Romero Gomez and Leila Kara and Quentin M Anstee and Jörn Schattenberg},
journal = {The Lancet regional health. Europe},
year = {2026},
month = oct,
doi = {10.1016/j.lanepe.2026.101893},
url = {https://europepmc.org/article/MED/42999578},
note = {CC BY},
}
RIS
TY - JOUR
TI - Health-care burden of metabolic dysfunction-associated steatotic liver disease in European tertiary-care outpatient clinics (CONSTANS): a prospective multicentre cohort study.
AU - Vlad Ratziu
AU - Jean-François Dufour
AU - Maharajah Ponnaiah
AU - Raluca Pais
AU - Maximilian Thormann
AU - Elisabetta Bugianesi
AU - Fabio Marra
AU - Marie Boyle
AU - Kate Hallsworth
AU - Silvia Aspite
AU - Sylvia Drazilova
AU - Federico Ravaioli
AU - Manuel Romero Gomez
AU - Leila Kara
AU - Quentin M Anstee
AU - Jörn Schattenberg
PY - 2026
DA - 2026/10/29
JO - The Lancet regional health. Europe
DO - 10.1016/j.lanepe.2026.101893
UR - https://europepmc.org/article/MED/42999578
AB - Despite modeling-based epidemiological studies of MASLD, precise estimates of the prevalence and health-care resource utilization in outpatient clinical practice are unknown. We assessed, in a real-life setting, the prevalence of suspected/confirmed MASLD and described health-care resource utilization. A prospective, observational study of patients attending the outpatient hepato-gastroenterology clinics of eight European tertiary care centers during three months. Follow-up data of patients with suspected/confirmed MASLD were recorded 12 months after the screening visit: final diagnosis, disease stage, diagnostic work-up and the use of health-care resources. 5240 outpatients from Germany, France, United Kingdom, Switzerland, Italy, Spain and Slovakia were screened. The main reasons for visit were: chronic viral hepatitis, 33.4% (1749/5240), miscellaneous hepatobiliary conditions including neoplasms, 32.9% (1725/5240) and known/suspected MASLD, 24.7% (1293/5240) (pooled prevalence of 26.1% (95% CI: 19.1-34.7)). 1134 suspected/confirmed MASLD patients were included, the diagnosis was confirmed in 80.2% (909/1134). Significant fibrosis was documented in 22.7% (257/1134) and cirrhosis (including burn-out MASLD) in 21.3% (241/1134). Procedures performed differed between countries, overall 66.4% (753/1134) had imaging studies, 65.3% (740/1134) non-invasive fibrosis tests, 20.4% (231/1134) liver biopsy, while referral for further cardiometabolic assessment or therapy was minimal (144/1134, 15.8%). The cost of all procedures and visits was in the range of that recommended for exploring hepatitis C before treatment, although highly variable between countries. MASLD was the second most frequent single cause for outpatient visits in eight European tertiary care centers. Significant fibrosis including cirrhosis was diagnosed in 44% of patients. The cost of required additional visits and procedures was equivalent to that recommended for hepatitis C before antiviral treatment. IMI2-Grant Agreement 777377-LITMUS.
SN - 2666-7762
ER -