Robert S. Brown
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View article: A global comparison of hepatitis B & C drug pricing
A global comparison of hepatitis B & C drug pricing Open
HBV and HCV originator medications cost significantly more in the US compared to seven other major industrial countries. However, the introduction of HBV generic medications has lowered the cost of treatment for patients in the US. Future …
View article: A Global Comparison of Liver Transplant Drug Pricing: US Versus Other G7 Countries and Australia
A Global Comparison of Liver Transplant Drug Pricing: US Versus Other G7 Countries and Australia Open
Background. A major contributor to increased healthcare spending in the United States is drug pricing, as US drug prices are nearly 3× higher than those in other countries. This cross-sectional study aimed to investigate current global pri…
View article: The impact of liver transplantation on endpoint selection in alcohol-associated hepatitis trials
The impact of liver transplantation on endpoint selection in alcohol-associated hepatitis trials Open
Background: Alcohol-associated hepatitis (AH) is a serious liver disease caused by heavy alcohol consumption with severe cases exhibiting a 90-day mortality rate of ~30%. No drugs have been approved for AH, and regulatory approval currentl…
View article: Screening and management of portal hypertension and varices in cirrhosis: Expert perspectives
Screening and management of portal hypertension and varices in cirrhosis: Expert perspectives Open
The prevalence of liver injury, fibrosis, and, in particular, cirrhosis in the United States is increasing in parallel to the current epidemic of metabolic dysfunction–associated steatotic liver disease and alcohol-associated liver disease…
View article: Who transitions into post-secondary education and why? A systematic review of the Canadian landscape
Who transitions into post-secondary education and why? A systematic review of the Canadian landscape Open
Decades of research have documented rates of student transitions into post-secondary education (PSE). A large majority of secondary students expect to obtain some level of PSE and are either motivated by their own personal interest, parent…
View article: Examining the Impact of Self-Contained Special Education Classes on Students’ Academic Achievement, Social Belonging, and Engagement in School: A Systematic Literature Review
Examining the Impact of Self-Contained Special Education Classes on Students’ Academic Achievement, Social Belonging, and Engagement in School: A Systematic Literature Review Open
Through this systematic literature review we examine the impact of self-contained special education classes on students’ academic outcomes, experiences of belonging, and school engagement. Overall, the results of this systematic review dem…
View article: Alcohol Use Disorder and Alcohol-Associated Liver Disease: New Definitions, Screening, and Treatment.
Alcohol Use Disorder and Alcohol-Associated Liver Disease: New Definitions, Screening, and Treatment. Open
Alcohol-associated liver disease (ALD) poses a significant global health burden and is a leading cause of liver-related morbidity and mortality. ALD encompasses a spectrum of disease states ranging from asymptomatic steatosis to acute hepa…
View article: Relationship between updated MELD and prognosis in alcohol-associated hepatitis: Opportunities for more efficient trial design
Relationship between updated MELD and prognosis in alcohol-associated hepatitis: Opportunities for more efficient trial design Open
Background: Alcohol-associated hepatitis (AH) is associated with significant mortality. Model for End-Stage Liver Disease (MELD) score is used to predict short-term mortality and aid in treatment decisions. MELD is frequently updated in th…
View article: Embedded Barriers and Impending Costs: The Relationship between Disability, Public Schooling, Post-Secondary Education, and Future Income Earnings
Embedded Barriers and Impending Costs: The Relationship between Disability, Public Schooling, Post-Secondary Education, and Future Income Earnings Open
In Canada, access to post-secondary education (PSE), which includes university, college, or apprenticeship programs, is becoming ever more important in terms of securing future employment, long-term health, and economic security. Kirby (20…
View article: Serum aryl hydrocarbon receptor activity is associated with survival in patients with alcohol-associated hepatitis
Serum aryl hydrocarbon receptor activity is associated with survival in patients with alcohol-associated hepatitis Open
Background and Aims: Patients with alcohol-associated hepatitis (AH) have an altered fecal metabolome, including reduced microbiota-derived tryptophan metabolites, which function as ligands for aryl hydrocarbon receptor (AhR). The aim of t…
View article: Meaningful Endpoints for Idiopathic Pulmonary Fibrosis (IPF) Clinical Trials: Emphasis on ‘Feels, Functions, Survives’. Report of a Collaborative Discussion in a Symposium with Direct Engagement from Representatives of Patients, Investigators, the National Institutes of Health, a Patient Advocacy Organization, and a Regulatory Agency
Meaningful Endpoints for Idiopathic Pulmonary Fibrosis (IPF) Clinical Trials: Emphasis on ‘Feels, Functions, Survives’. Report of a Collaborative Discussion in a Symposium with Direct Engagement from Representatives of Patients, Investigators, the National Institutes of Health, a Patient Advocacy Organization, and a Regulatory Agency Open
Background: Idiopathic pulmonary fibrosis (IPF) carries significant mortality and unpredictable progression, with limited therapeutic options. Designing trials with patient-meaningful endpoints, enhancing the reliability and interpretabili…
View article: Narrative review of management of cirrhosis during the treatment of hepatocellular carcinoma
Narrative review of management of cirrhosis during the treatment of hepatocellular carcinoma Open
The management of cirrhosis and HCC are both complex and interrelated. Through a multidisciplinary team approach we can best treat the complications of cirrhosis, allow for expanded treatment options, and improve quality of life through sy…
View article: Non‐invasive markers of inflammation in alcohol‐associated liver disease: A scoping review
Non‐invasive markers of inflammation in alcohol‐associated liver disease: A scoping review Open
Clinical manifestations of liver inflammation in alcohol‐associated liver disease (ALD) can range from asymptomatic to severe alcoholic hepatitis. While biopsy is the gold standard for identifying liver inflammation, it is an invasive proc…
View article: Precipitous changes in nomenclature and definitions—NAFLD becomes SLD: Implications for and expectations of AASLD journals
Precipitous changes in nomenclature and definitions—NAFLD becomes SLD: Implications for and expectations of AASLD journals Open
Recently a multi-stakeholder effort by the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of Liver Diseases (EASL), in collaboration with the Association Latinoamericana para el Estudio…
View article: Precipitous changes in nomenclature and definitions—NAFLD becomes SLD: Implications for and expectations of AASLD journals
Precipitous changes in nomenclature and definitions—NAFLD becomes SLD: Implications for and expectations of AASLD journals Open
Recently a multi-stakeholder effort by the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of Liver Diseases (EASL), in collaboration with the Association Latinoamericana para el Estudio…
View article: Improving the Management of Hepatorenal Syndrome-Acute Kidney Injury Using an Updated Guidance and a New Treatment Paradigm.
Improving the Management of Hepatorenal Syndrome-Acute Kidney Injury Using an Updated Guidance and a New Treatment Paradigm. Open
Cirrhosis, or advanced scarring of the liver, represents the end stage of chronic liver disease and is associated with high morbidity and mortality. Hepatorenal syndrome-acute kidney injury (HRS -AKI), a condition causing functional and pr…
View article: Opportunities to address gaps in early detection and improve outcomes of liver cancer
Opportunities to address gaps in early detection and improve outcomes of liver cancer Open
Death rates from primary liver cancer (hepatocellular carcinoma [HCC]) have continued to rise in the United States over the recent decades despite the availability of an increasing range of treatment modalities, including new systemic ther…
View article: Early initiation of glecaprevir/pibrentasvir after transplantation of HCV‐viremic kidneys into HCV‐negative recipients is associated with normalization in the altered inflammatory milieu
Early initiation of glecaprevir/pibrentasvir after transplantation of HCV‐viremic kidneys into HCV‐negative recipients is associated with normalization in the altered inflammatory milieu Open
Our previous Multicenter Trial to Transplant HCV‐infected Kidneys (MYTHIC) observed that 100% of hepatitis C virus (HCV)‐uninfected patients who received a kidney from an HCV‐infected deceased donor were cured of HCV with an 8‐week regimen…
View article: Evaluating sleep in covert encephalopathy with wearable technology: results from the WATCHES study
Evaluating sleep in covert encephalopathy with wearable technology: results from the WATCHES study Open
Background and Aims: Covert HE (CHE) is a common early stage of HE associated with poor outcomes. Available neuropsychiatric diagnostic testing is underutilized and has significant clinical limitations. Sleep deterioration is consistently …
View article: Management and Risks Before, During, and After Liver Transplant in Individuals With Obesity.
Management and Risks Before, During, and After Liver Transplant in Individuals With Obesity. Open
Obesity has become a global epidemic, adding to the burden of chronic diseases and disabilities. Metabolic syndrome, especially obesity, is a significant risk factor for nonalcoholic fatty liver disease, which is the most common indication…
View article: Safety analysis of glecaprevir/pibrentasvir in patients with markers of advanced liver disease in clinical and real‐world cohorts
Safety analysis of glecaprevir/pibrentasvir in patients with markers of advanced liver disease in clinical and real‐world cohorts Open
Chronic hepatitis C virus (HCV) infection has the greatest health impact in patients with advanced liver disease. The direct‐acting antiviral (DAA) regimen glecaprevir/pibrentasvir (G/P) is approved for treatment of HCV‐infected patients w…
View article: Bebtelovimab for Treatment of COVID-19 in Ambulatory Solid Organ Transplant Recipients
Bebtelovimab for Treatment of COVID-19 in Ambulatory Solid Organ Transplant Recipients Open
Solid organ transplant recipients (SOTR) are at a higher risk of morbidity and mortality from COVID-19.1 COVID-19 therapeutics have been used in ambulatory SOTR in an effort to avoid hospitalization and other morbidity.2,3 However, because…
View article: Ten-Year Outcomes of Liver Transplant and Downstaging for Hepatocellular Carcinoma
Ten-Year Outcomes of Liver Transplant and Downstaging for Hepatocellular Carcinoma Open
In a large, multicenter cohort of patients with HCC successfully downstaged to within MC, 10-year post-LT outcomes were excellent, validating national downstaging policies and showing a clear utility benefit for LT prioritization decision …
View article: Effect of rifaximin on infections, acute‐on‐chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA‐AH)
Effect of rifaximin on infections, acute‐on‐chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA‐AH) Open
Background & Aims Alcoholic hepatitis (AH) is associated with a high incidence of infection and mortality. Rifaximin reduces bacterial overgrowth and translocation. We aimed to study whether the administration of rifaximin as an adjuvant t…