Users

stories:

interview

with

Stephen

Esposito

FibroScan^® helps identify high-risk patients that you wouldn’t discover otherwise. Up to 60% of our NASH patients have normal liver enzymes. It may be difficult without a liver biopsy or a FibroScan^® to know the status of their liver disease.

Stephen Esposito| M.D., Hepatobiliary Associates of NY, New York Presbyterian Hospital, USA

For which etiologies do you primarily use FibroScan^®?

Basically,

anything

involving

the

liver.

use

with

fatty

liver

(NAFLD),

hepatitis

alcoholic

liver

disease,

NASH,

some

the

auto-immune

diseases,

and

for

patients

with

hemochromatosis.

FibroScan

^®

simple,

safe

and

cost-effective

screening

test

for

us.

Are there conditions where FibroScan^® has proven especially helpful?

The

first

thing

that’s

important

me,

for

all

the

patients

our

practice,

get

baseline—for

all

liver

patients.

From

there,

you

may

have

different

questions

for

each

disease:

For

example,

with

HCV

patients,

use

FibroScan®

approve

anti-viral

medicines,

even

though

many

states

have

dropped

the

fibrosis

requirement,

we’ve

seen

much

faster

approvals

for

anti-virals

when

include

the

FibroScan

^®

results

versus

blood

test

alone.

With

HBV

patients,

you’ll

face

different

scenario.

Their

lab

results

may

reveal

normal

ALT,

negative

HBV

EAg,

and

their

fibrosis

may

very

variable.

can

use

FibroScan

^®

data

decide

which

patients

may

benefit

from

the

administration

antiviral

medicines.

Does deeper insight into the amount of fibrosis affect your treatment plan?

When

can

actually

measure

how

much

fibrosis

present

with

patient,

can

determine

those

who

may

higher

risk

for

other

conditions.

So,

for

example,

might

recommend

closer

screenings

for

hepatocellular

carcinoma,

might

want

endoscopy

look

for

portal

hypertension.

When

see

heightened

stiffness

score

–

say

kPa

above

–

know

that

this

patient

risk

for

liver-averse

event.

can’t

tell

you

how

many

times

we’ve

seen

someone

with

normal

platelet

count

have

significant

fibrosis.

FibroScan

^®

helps

identify

high-risk

patients

that

you

wouldn’t

discover

otherwise.

60%

our

NASH

patients

have

normal

liver

enzymes.

may

difficult

without

liver

biopsy

FibroScan

^®

know

the

status

their

liver

disease.

How do patients react to FibroScan^®?

think

that

our

patients

find

very

encouraging,

the

whole.

have

patient

with

SVR,

for

example,

can

track

progression

their

fibrosis.

think

they

find

very

encouraging

see

concrete

metric

showing

their

liver

getting

better.

Have you noticed any changes in practice referrals?

Historically,

the

majority

our

patients

come

from

PCPs,

but

I’m

starting

get

higher

number

other

gastroenterologists

referring

specific

patients

well.

think

those

doctors

are

beginning

understand

the

advantages

the

FibroScan

^®

exam

–

and

try

reassure

them

that

the

patients

will

return

them

for

their

endoscopies

colonoscopies.

With

our

FibroScan

^®

have

also

noticed

increases

our

radiology

practice,

work

catch

disease

states

sooner.

now

have

sonogram

tech

who

visits

the

practice

twice

weekly.

Overall,

think

we’ve

tracked

increase

patient

volume

maybe

10%

15%,

most

notably,

have

seen

increase

endoscopic

procedures

What is your overall assessment of having FibroScan^® in your practice?

Honestly,

can’t

imagine

life

without

FibroScan

^®

now.

don’t

know

how

practiced

without

it.

has

really

changed

workup

patient.

some

cases,

it’s

become

important,

me,

than

endoscopy.

has

improved

our

entire

practice

the

sense

that

feel

comfortable

knowing

which

patients

need

worry

about,

which

patients

require

frequent

re-calls

and

forth.

And

believe

that

physicians

and

payers

are

coming

understand

the

benefits

well.

This

diagnostic

test

will

pick

out

people

high

risk

that

other

routine

test

going

find,

unless

you’re

going

scan

every

patient.

you

think

about

it,

you

uncover

that

one

cirrhotic

liver,

you

save

that

one

trip

the

with

variceal

bleed,

you

understand

how

beneficial

that

can

be.

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Users stories: interview with Stephen Esposito

Always be informed about liver health

Users

stories:

interview

with

Stephen

Esposito