Dr. Ashwin Pachaatt Vinod
pachaatt.bsky.social
Dr. Ashwin Pachaatt Vinod
@pachaatt.bsky.social
DM Hepatology Resident, PGIMER Chandigarh, AIIMS New Delhi and Raipur Alumni. Navodayan.
Reposted by Dr. Ashwin Pachaatt Vinod
The greatest review written on liver biopsy: indications, interpretation, and its future

By Dr Purva Gopal and colleagues in HepCommJournal

Open access journals.lww.com/hepcomm/full...

#liversky #pathsky
January 9, 2025 at 12:46 AM
Reposted by Dr. Ashwin Pachaatt Vinod
Albumin is the closest thing to a "universal remedy" in cirrhosis

We use it to treat different complications, with good evidence but also with debatable or negative evidence

Excellent analysis by Jonel Trebicka & @ggarciatsao.bsky.social

doi.org/10.1097/hep.0000000000000521

#LiverSky
January 4, 2025 at 11:11 AM
Reposted by Dr. Ashwin Pachaatt Vinod
This is an awesome review on the role of the thyroid hormone in liver disease

The way Dr Ritter explains this will get you excited for:

1. Hepatoendocrinology
2. The future of thyroid receptor agonists
3. Her impact on the field

journals.lww.com/hepcomm/full... #liversky
December 20, 2024 at 1:06 AM
Reposted by Dr. Ashwin Pachaatt Vinod
Incidence of cancer in PSC

#liversky
January 2, 2025 at 1:57 AM
Reposted by Dr. Ashwin Pachaatt Vinod
I once lost a debate in spectacular fashion to @brettefortune.bsky.social. Popular vote landslide AND electoral college

He was for early TIPS after variceal bleeding. I was against

My points were:

#liversky
⚠️ A recent study in patients with cirrhosis and portal hypertension shows that preoperative placement of TIPS is associated with increased postoperative mortality 🤨

doi.org/10.1097/hc9....

#LiverSky #MedSky
January 4, 2025 at 7:27 PM
Reposted by Dr. Ashwin Pachaatt Vinod
Fibrates and other PPAR agonists are so hot right now

Here is a review of how they work, the evidence of benefit, and the bright future of this pathway in improving liver health

journals.lww.com/hepcomm/full...
PPAR agonists for the treatment of cholestatic liver... : Hepatology Communications
and the risk of progression to cirrhosis and liver failure. First-line therapy for PBC is ursodeoxycholic acid, although up to 40% of treated individuals are incomplete responders, and there is no eff...
journals.lww.com
December 20, 2024 at 1:13 AM
Reposted by Dr. Ashwin Pachaatt Vinod
Early Terli

Giving terlipressin at lower creatinines (1.5-2.0) or within 12 hours of presentation (skipping the “albumin challenge”)

1. From the RCTs journals.lww.com/hepcomm/page...
2. Pilot trial doi.org/10.1007/s106...

#liversky
Image Gallery : Early treatment with terlipressin in patients with hepatorenal syndrome yields improved clinical outcomes in North American studies : Hepatology Communications
journals.lww.com
December 23, 2024 at 12:15 AM
Reposted by Dr. Ashwin Pachaatt Vinod
Can de-novo lipogenesis pathways be targeted to treat metabolic dysfunction-associated steatohepatitis?

The FASCINATE-2 trial explored the effects of denifanstat, an inhibitor of fatty acid synthase, in this setting

www.thelancet.com/journals/lan...

#LiverSky #MedSky
Denifanstat for the treatment of metabolic dysfunction-associated steatohepatitis: a multicentre, double-blind, randomised, placebo-controlled, phase 2b trial
Treatment with denifanstat resulted in statistically significant and clinically meaningful improvements in disease activity, MASH resolution, and fibrosis. The results of this phase 2b trial support the advancement of denifanstat to phase 3 development.
www.thelancet.com
December 20, 2024 at 9:35 AM
Reposted by Dr. Ashwin Pachaatt Vinod
We're closing out the year with our annual editors' selection of highlights from The Lancet Gastroenterology & Hepatology

Follow the🧵below!

#GastroSky #LiverSky #MedSky
December 20, 2024 at 8:56 AM
Reposted by Dr. Ashwin Pachaatt Vinod
Really good review for those of us who are not always digging into statistical methods #livertwitter

evidence.nejm.org/doi/full/10....
Treating Patients, Not P Values
To the dismay of many statisticians, clinicians are taught to convert continuous results into a binary value to facilitate decision-making. A person with a hemoglobin A1c level of 6.5% or higher ha...
evidence.nejm.org
December 21, 2024 at 3:22 PM
Reposted by Dr. Ashwin Pachaatt Vinod
Updated HCC management guidelines by @easlnews.bsky.social

Must read 👇🏼👇🏼👇🏼

www.journal-of-hepatology.eu/article/S016...

#Liversky
December 17, 2024 at 12:48 PM
Reposted by Dr. Ashwin Pachaatt Vinod
New Review - The liver–brain axis in metabolic dysfunction-associated steatotic liver disease

www.thelancet.com/journals/lan...
December 17, 2024 at 7:07 AM
Reposted by Dr. Ashwin Pachaatt Vinod
Proposed algorithm for selecting patients with MASH for treatment with resmetirom at #TLM2024 #LiverSky
November 15, 2024 at 4:55 PM
Reposted by Dr. Ashwin Pachaatt Vinod
Drugs for Mash cirrhosis by Prof Mazen Noureddin #TLM24
November 15, 2024 at 5:03 PM
Reposted by Dr. Ashwin Pachaatt Vinod
Anand Kulkarni presents data from the STASH trial of dose tapering vs fixed dose corticosteroids in patients with severe alcohol-associated hepatitis #TLM24 #LiverSky
November 18, 2024 at 11:18 PM
Reposted by Dr. Ashwin Pachaatt Vinod
Dose tapering reduced incidence of infection and use of antibiotics. No difference noted in survival #TLM24 #LiverSky
November 18, 2024 at 11:24 PM
Reposted by Dr. Ashwin Pachaatt Vinod
#TLM24 #LiverSky #IDsky

MTE #3: HCV and Coinfections with Other Types of Viral Hepatitis

➡️ Management of HBsAg+ persons prior to HCV DAA

Reminders :
- HBsAg+ ❌ simplified Tx
- HBV reactivation = 24% if HBsAg+ and ALT ⬆️ 9%
- Risk of HBV DNA ⬆️ isolated anti-HBc is low (1.4%) & ALT ⬆️ ~0%.
November 17, 2024 at 12:55 AM
Reposted by Dr. Ashwin Pachaatt Vinod
Christopher Bowlus shares data from
the SPRING phase 2 RCT of CM-101, a monoclonal antibody that neutralises CCL24, in patients with primary sclerosing cholangitis #TLM24 #LiverSky
November 18, 2024 at 10:48 PM
Reposted by Dr. Ashwin Pachaatt Vinod
❗Very impressive data 👀
by Bluejay therapeutics #TLM24

BJT-778,anti-HBsAg monoclonal Ab, achieved 100% virologic response in subjects w/ chronic hep D : phase 2

BJT-778 MoA
-Neutralize infectious HBV & HDV
-Deplete HBsAg-contained particles
-Presentation to & activation of T cell

#Liversky #IDSky
November 20, 2024 at 3:26 AM
Reposted by Dr. Ashwin Pachaatt Vinod
Mazen Noureddin presents data from a ph 2 trial of efimosfermin alfa (BOS-580), a long acting (once monthly) FGF21 analogue, in patients with MASH and F2/F3 fibrosis #TLM24 #LiverSky
November 19, 2024 at 7:08 PM
Reposted by Dr. Ashwin Pachaatt Vinod
Nice to see Kavish Patidar recognizing our work led by Paige McLean Diaz on RRT decision-making in transplant ineligible patients at #TLM24. Is it time to trial serious illness communication & TLT interventions in the ACLF space? #palliativehepatology #LiverSky #NephSky @juancarlosqvelez.bsky.social
November 18, 2024 at 8:49 PM
Reposted by Dr. Ashwin Pachaatt Vinod
Everything you need to know about #cirrhosis in one picture?

Judge for yourself

pmc.ncbi.nlm.nih.gov/articles/PMC...
#medsky #liversky
November 12, 2024 at 12:21 AM
Reposted by Dr. Ashwin Pachaatt Vinod
New at The Lancet Child & Adolescent Health — Paediatric acute liver failure: a multidisciplinary perspective on when a critically ill child is unsuitable for liver transplantation

www.thelancet.com/journals/lan...

#LiverSky
Paediatric acute liver failure: a multidisciplinary perspective on when a critically ill child is unsuitable for liver transplantation
Paediatric acute liver failure is a devastating condition with high morbidity and mortality, which is challenging to manage for the hepatologist, intensivist, and associated specialists. Emergency liv...
www.thelancet.com
November 20, 2024 at 1:30 PM
Reposted by Dr. Ashwin Pachaatt Vinod
Pearls from « Viral Hepatitis and Immunosuppression : When to Screen and When to Treat »

#TLM24 #Liversky #IDsky

➡️ Screening Recommendations for prevention of HBV reactivation

(no current recommendations for any other viral hepatitis screening)

Use triple panel test
= HBsAg, HBcAb, HBsAb
November 18, 2024 at 7:49 PM