Clinical trials to unlock treatment for liver disease

Dr Koya Ayonrinde stands in a corridor inside Fiona Stanley Hospital
Fiona Stanley Hospital gastroenterologist and hepatologist Dr Koya Ayonrinde
July 22, 2019

Finding a treatment for his patients is what drives gastroenterologist and hepatologist Dr Koya Ayonrinde, who has been researching non-alcoholic fatty liver disease (NAFLD) and its severe form, non-alcoholic steatohepatitis (NASH), for more than a decade.

Leading four international clinical trials at Fiona Stanley Hospital (FSH) Dr Ayonrinde has his sights set on contributing to finding a treatment to help people with NASH.

NASH is present when there is inflammation and scarring of an already fatty liver that is not due to alcohol. It is a more severe form of NAFLD, which affects about 25 per cent of the population, including 15 per cent of teenagers in Perth.

Dr Ayonrinde said NASH increases the risk of other chronic health conditions such as diabetes, heart attack and stroke and is on the rise.  

“We have seen an increase in prevalence of NASH. In the South Metropolitan Health Service catchment, the population has a high prevalence of risk factors for NAFLD and NASH, consequently rates of liver cirrhosis and liver cancer developing from NASH are rising,” Dr Ayonrinde said.

NASH is commonly seen in overweight or obese people, those with diabetes or pre diabetes, abnormal cholesterol levels or high blood pressure and is commonly associated with an unhealthy diet and inadequate exercise. Yet Dr Ayonrinde said intervention beyond lifestyle changes was needed.

“Finding a way to improve the health of our patients is critical as there is no approved treatment for NASH in Australia, yet it is a $35 billion a year disease worldwide, which is flying under the radar,” Dr Ayonrinde said.

“One in 20 people with NAFLD will have NASH, of those one in 10 people will progress to liver cirrhosis, while about one in 250 will develop liver cancer. We hope by identifying this cohort of people early and intervening with treatment, such complications can be reduced.

“We currently have four clinical trials underway at FSH, testing different drugs to determine which can help reduce the burden of disease on sufferers and the community.”

FSH is one of the highest recruiting sites for these clinical trials in Australia, with almost 20 participants. Hundreds of patients have been screened to join, but recruitment can be difficult and slow when requiring this specific patient type.

Participants are required to undergo a pre-screening biopsy to confirm diagnosis of NASH, then take oral medication once a day. Follow up assessments and a repeat biopsy mid-way and at the end of treatment help assess for efficacy. Study participation varies between the clinical trials, but can range from two to seven years, which includes follow up visits.

Dr Ayonrinde continues his quest into this burgeoning disease and is hopeful of an outcome for patients soon.

“These trials are a good opportunity to examine a disease without treatment and one that is not well understood, as we have a real potential to make a difference with later interventions.”

For more information to become involved in these clinical trials, phone 6151 1221.

Learn more about the diverse research activity conducted across South Metropolitan Health Service sites in the 2018 Research Report (external site), including sponsored clinical drug trials, national and international collaborative trials and locally initiated projects aiming to improve patient outcomes.

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