The use of AGILE 3+ and AGILE 4 for the prediction of advanced fibrosis and cirrhosis in patients with Non-Alcoholic Fatty Liver Disease

• Published in: Digestive and liver disease 2023-03, Vol.55, p.S31-S32
• Main Authors: Gjini, K., Armandi, A., Caviglia, G.P., Rosso, C., Castelnuovo, G., Perez-Diaz-Del-Campo, N., Ribaldone, D.G., D'Amato, D., Abdulle, A., Saracco, G.M., Bugianesi, E.
• Format: Article
• Language: English
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2023.01.060

non-invasive assessment of advanced fibrosis in Non-Alcoholic Fatty Liver Disease (NAFLD) is crucial for the identification of patients at greatest risk of progression. Among non-invasive tests, AGILE 3+ and AGILE 4 have been recently proposed, combining liver stiffness measurement (LSM) by vibration-controlled transient elastography (FibroScan) with clinical-biochemical variables. we aimed to assess the accuracy of AGILE 3+ and AGILE 4 for the identification of advanced fibrosis (F3-F4) and cirrhosis (F4), respectively, against LSM in individuals with biopsy-proven NAFLD. we retrospectively included 315 biopsy-proven NAFLD patients. No clinical, radiological or biochemical signs of cirrhosis were present at inclusion. Clinical-biochemical data and LSM were collected at time of the biopsy. median age was 48 (IQR 38-47) years, 62% were male. Median LSM was 7.5 kPa (IQR 5.8-10.1). Advanced fibrosis was present in 28%, cirrhosis in 10% and NASH in 28% of cases. Eighty subjects had type 2 diabetes. At Area Under the Curve (AUC) analysis, LSM had a value of 0.807 (Se 70%, Sp 80%) for advanced fibrosis and 0.877 (Se 88%, Sp 76%) for cirrhosis. AGILE 3+ had AUC of 0.77 for advanced fibrosis (cut-off by Youden index 0.30, Se 68%, Sp 78%), while AGILE 4 had AUC of 0.78 for cirrhosis (cut-off by Youden index 0.11, Se 55%, Sp 89%). Comparison of AUC showed that AGILE 3+ was similar to LSM for identifying advanced fibrosis (DeLong p= 0.254). Similarly, AUC comparison between LSM and AGILE 4 for cirrhosis was not different (DeLong p=0.739). when compared to LSM, AGILE 3+ and AGILE 4 had similar accuracy for the detection of advanced fibrosis and cirrhosis in NAFLD patients. This research was supported by the Italian MIUR “Dipartimenti di Eccellenza 2018-2022” D15D18000410001 and by Horizon 2020, no.777377, LITMUS.