HCPLive Podcasts

In this episode of Liver Lineup, hosts Nancy Reau, MD, and Kimberly Brown, MD, are joined by Saul Karpen, MD, PhD, and Robert Gish, MD, for a practical, clinician-focused discussion on the evolving role of genetic testing in cholestatic liver disease.As genetic panels become more widely used in hepatology, many clinicians are left wondering when to order these tests—and how to interpret the results when they come back. From unexplained cholestasis and AMA-negative PBC to intrahepatic cholestasis of pregnancy and atypical liver enzyme patterns, the conversation explores where genetic testing can add real clinical value.Karpen and Gish break down the basics of modern genetic panels, including how they’ve evolved over time, what clinicians should look for in results, and how to approach common challenges like variants of uncertain significance (VUS). The discussion also highlights key genes, such as ABCB4 and ABCB11, and explains how genetic findings can influence diagnosis, risk assessment, and treatment decisions.Read more: https://www.hcplive.com/view/liver-lineup-navigating-genetic-testing-in-cholestatic-liver-disease

Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let’s dive into the latest updates impacting clinicians and healthcare providers like you!Interested in a more traditional, text rundown? Check out the HCPFive!RAINIER: Povetacicept Reduces Proteinuria By 52.0%A pre-specified week 36 interim analysis of the phase 3 RAINIER trial found that povetacicept, a dual BAFF/APRIL inhibitor, reduced proteinuria by 52% from baseline and achieved a statistically significant 49.8% reduction in UPCR versus placebo in patients with IgA nephropathy.Lorundrostat Secures FDA NDA Acceptance for Hypertension, Falls Short in Phase 2 OSA TrialThe FDA accepted Mineralys Therapeutics' NDA for lorundrostat as an add-on treatment for hypertension, supported by phase 3 and phase 2 trial data, with a PDUFA action date set for December 22, 2026.Discontinuing GLP-1 Treatment Associated With Up to 60% Weight Regain, With Brajan BudiniNew findings indicate that stopping GLP-1 receptor agonist therapy leads to a predictable pattern of weight regain—reaching approximately 60% at one year before plateauing—suggesting meaningful but substantially diminished long-term benefit after cessation.FDA Approves Leucovorin Calcium (Wellcovorin) Tablets as First Cerebral Folate Deficiency TreatmentThe FDA approved GSK's leucovorin calcium tablets as the first treatment for cerebral folate deficiency in patients with a confirmed FOLR1 gene variant, based on a systematic review of published literature and mechanistic data.New Long-Term Data Announced on Roflumilast Cream for Atopic Dermatitis in ChildrenLong-term data from the INTEGUMENT-OLE extension study show that once-daily roflumilast cream 0.05% is safe and well-tolerated in children aged 2 to 5 with mild-to-moderate atopic dermatitis, with efficacy not only sustained but continuing to improve through 56 weeks of treatment.

Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let’s dive into the latest updates impacting clinicians and healthcare providers like you!Interested in a more traditional, text rundown? Check out the HCPFive!MAJESTY: Obinutuzumab Achieves 2 Year Complete Remission in Primary Membranous NephropathyObinutuzumab demonstrated superior complete remission rates at 2 years compared with tacrolimus in primary membranous nephropathy in the phase 3 MAJESTY trial, supporting a potential new B-cell–targeted standard of care.Ixekizumab, Tirzepatide Effective Together for Psoriasis and Obesity or OverweightIn adults with moderate-to-severe plaque psoriasis and obesity or overweight, combination therapy with ixekizumab and tirzepatide achieved superior skin clearance and weight reduction at 36 weeks compared with ixekizumab alone.AREXVY Vaccine Reduces Hospitalization, Major Adverse Cardiovascular Events in RSVReal-world data from over 2.5 million patients showed GSK’s AREXVY vaccine was 75.6% effective against RSV-related hospitalization, with additional signals suggesting reduced in-hospital major adverse cardiovascular events in older adults.COMP360 Psilocybin Meets Primary Endpoint in Second Phase 3 Trial for TRDCOMP360 synthetic psilocybin met the primary endpoint in its second phase 3 trial in treatment-resistant depression, demonstrating significant symptom reduction at week 6 versus low-dose control and advancing toward potential regulatory submission.Thykamine Shows Disease-Modifying Potential in MASH Using Liver-on-a-Chip PlatformPreclinical data using a human liver-on-a-chip model suggest Thykamine may exert dose-dependent antifibrotic and anti-inflammatory effects in MASH, supporting further translational development.

Accurately defining the population of patients with short bowel syndrome (SBS) and intestinal failure has long been a challenge in gastroenterology. In an effort to bring greater clarity to the field, Alan Buchman MD, MSPH, a professor of Clinical Surgery and Medical Director of the Intestinal Rehabilitation and Transplant Center at the University of Illinois at Chicago and director of gastroenterology at Elevance Health, led the introduction of new, more specific ICD-10-CM codes for SBS, along with corresponding updates to World Health Organization ICD-11 classifications. His recent real-world US claims analysis presented at the ASPEN 2026 Nutrition Science and Practice Conference examined how widely those codes have been adopted and what that adoption, or lack thereof, reveals about disease burden and clinical practice.Key Interview Time Stamps0:00:00 What prompted this analysis of ICD code adoption in short bowel syndrome?0:01:17 Key findings 0:03:33 Understanding reasons for variability in code adoption0:04:36 The potential benefits of improved coding accuracy

Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let’s dive into the latest updates impacting clinicians and healthcare providers like you!Interested in a more traditional, text rundown? Check out the HCPFive!Top 5 Healthcare Headlines for February 1-7, 2026:1. FDA Issues CRL to Dibutepinephrine (Anaphylm) Sublingual Film for Type 1 Allergic ReactionsThe FDA issued a Complete Response Letter for sublingual dibutepinephrine after identifying human factors issues that could compromise safe use during anaphylaxis, underscoring the importance of reliable administration in emergency settings.2. Positive Topline Data Released on Roflumilast Cream in Infants with Atopic DermatitisPhase 2 data indicate roflumilast cream was well tolerated in infants with atopic dermatitis and showed early signs of clinical improvement, supporting potential expansion of topical PDE4 inhibition into this very young population.3. FDA Accepts Resubmitted BLA for RelabotulinumtoxinA for Glabellar and Lateral Canthal LinesThe FDA accepted Galderma’s resubmitted BLA for relabotulinumtoxinA following manufacturing process updates, allowing regulatory review to resume for treatment of glabellar and lateral canthal lines.4. Upadacitinib Regulatory Applications Submitted for Adults, Adolescents with VitiligoAbbVie submitted regulatory applications seeking to expand upadacitinib use to adults and adolescents with non-segmental vitiligo, positioning a systemic JAK inhibitor as a potential option for this underserved condition.5. VESPER-3: Positive Results of Long-Term GLP-1 PF’3944 in Overweight and Obesity Without T2DPositive phase 2b results suggest Pfizer’s long-acting GLP-1 receptor agonist may support sustained weight management with extended dosing intervals in patients without diabetes.

In this episode of Liver Lineup: Updates and Unfiltered Insights, Nancy Reau, MD, and Kimberly Brown, MD, turn their attention to metabolic dysfunction–associated steatotic liver disease (MASLD) and metabolic dysfunction–associated steatohepatitis (MASH), conditions that now dominate hepatology clinics but continue to pose major diagnostic and therapeutic challenges. As new drugs enter the clinic and others advance through the pipeline, the hosts explore what meaningful progress looks like in a disease space defined by heterogeneity, comorbidities, and ongoing uncertainty around long-term outcomes.Key episode timestamps:0:00:00 – Intro + global MASLD burden and mortality; who progresses to severe liver disease.0:03:00 – Very low disease awareness; advanced MASLD often missed.0:06:32 – Weak FIB‑4–based referral patterns; need automated pathways.0:10:54 – Alcohol underreporting; role of PEth in honest discussions.0:15:18 – “Modest” alcohol still harmful in MASLD; no truly safe level.0:19:40 – Semaglutide/GLP‑1 benefits on liver outcomes beyond weight loss.0:23:22 – FGF‑21 agents improving portal hypertension in advanced disease.0:24:03 – Carvedilol less effective for variceal bleed prevention in MASLD.0:28:45 – Closing remarks; call for better disease control and systems of care.

In this episode of Liver Lineup: Updates and Unfiltered Insights, hosts Nancy Reau, MD, and Kimberly Brown, MD, tackle a paradox that continues to define viral hepatitis care: despite curative therapies for hepatitis C and highly effective suppression for hepatitis B, global and domestic elimination goals remain out of reach. The conversation reframes viral hepatitis not as a “finished” chapter in hepatology, but as an ongoing public health challenge shaped by missed screening, gaps in linkage to care, and uneven adoption of evidence-based interventions.Key episode timestamps:0:00:00 – Hepatitis elimination gaps; dialysis-unit success; primary-care screening barriers.0:04:30 – Statins in HBV/HCV: reduced HCC/decompensation; safety in compensated disease.0:08:41 – GLP‑1 agonists: improved liver outcomes and cancer/cardiometabolic profile; safety concerns addressed.0:13:21 – HBV functional cure and Bepi: niche role, durability, small but meaningful responder group.0:19:28 – HBV/HDV: disease severity; new mAb + siRNA regimen; comparison with existing options; access issues.0:23:28 – Bulevirtide durability data; real‑world compassionate-use case with recompensation and early HCC.

In this episode of Liver Lineup: Updates and Unfiltered Insights, hosts Kimberly Brown, MD, and Nancy Reau, MD, break down new research on liver transplantation, hepatocellular carcinoma (HCC), and the ongoing evolution of surveillance strategies in chronic liver disease. Drawing on their extensive experience as transplant hepatologists, Brown and Reau place new data into practical context, highlighting where evidence may meaningfully inform practice and where unanswered questions remain.Key episode timestamps:0:00:00 – Introduction0:00:19 – Frailty & Transplant Evaluation0:02:54 – How Centers Use Frailty Measures0:04:37 – Practicalities of the Six‑Minute Walk0:06:10 – MELD 3.0 and Sex/Size Disparities0:08:42 – Exception Points & Size Constraints0:10:05 – Need for a Dynamic MELD System0:10:19 – Immunotherapy as Bridge/Downstaging for HCC0:13:34 – Real‑World Use of IO Around Transplant0:15:22 – Managing Rejection Risk0:19:03 – MASLD Population & Surveillance Gaps0:20:21 – Adherence to HCC Surveillance0:22:42 – Practical Barriers: AFP, Ultrasound, Radiology Reports0:24:02 – Shift Toward Blood-Based Surveillance0:26:01 – How AFP-L3 and DCP Are Used in Practice0:27:39 – Rising AFP, Imaging Strategy & Broader Trend to Blood Tests0:28:27 – Guidelines vs Real-World Practice0:29:37 – Closing Thoughts on Guidelines & Early Detection

In this episode of Liver Lineup: Updates and Unfiltered Insights, hosts Kimberly Brown, MD, and Nancy Reau, MD, break down several of the most consequential hepatology developments of 2025, focusing on practical advances in the management of patients with advanced liver disease. From renal protection in metabolic dysfunction-associated steatotic liver disease (MASLD) cirrhosis to long-debated questions around albumin dosing and emerging tools for monitoring hepatic encephalopathy at home, the discussion centers on how new data may begin to shift everyday clinical decision-making.Key episode timestamps:0:00:00 – Dapagliflozin in MASLD cirrhosis with ascites0:04:41 – Clinical perspective on dapagliflozin & management strategy0:06:37 – Albumin for hyponatremia in cirrhosis0:12:28 – How clinicians currently use albumin in practice0:18:43 – Low‑dose vs conventional‑dose albumin in high‑risk SBP 0:25:03 – Beacon device: at‑home critical flicker frequency for HE0:27:47 – Future of at‑home HE monitoring & closing remarks

In this episode of Liver Lineup: Updates & Unfiltered Insights, hosts Nancy Reau, MD, and Kim Brown, MD, take on a recent consequential and controversial public health decision: the US Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices’ (ACIP) vote to remove the universal birth-dose hepatitis B vaccine recommendation for infants born to mothers who test negative for HBV.Key episode timestamps:0:00:00 – Introduction and initial reactions0:01:40 – Hep B as an anti‑cancer vaccine & global perspective0:03:59 – Transmission, testing gaps, and implementation problems0:07:48 – Infant risk, carrier status, and long‑term protection0:10:14 – Broader health and oncology implications0:11:48 – Personal stance and closing thoughts

In this special edition episode of Liver Lineup, recorded as part of HCPLive's This Year in Medicine series, hosts Nancy Reau, MD, and Kimberly Brown, MD, break down the most consequential updates of the year across primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and autoimmune hepatitis (AIH), highlighting data that may reshape both near-term management and longer-term treatment strategies.Key episode timestamps:0:00:00 – Intro0:00:40 – Underuse of second‑line therapy in PBC0:03:40 – Long‑term data on PPAR agonists (elafibranor, seladelpar) in PBC0:09:35 – PSC: elafibranor (Elmwood trial) and CCL24 mAb (nabokitug)0:15:56 – Cholestasis symptoms: fatigue and pruritus and PPAR impact0:20:20 – Autoimmune hepatitis: limitations of current therapy; new agent

In this episode of Liver Lineup: Updates and Unfiltered Insights, hosts Nancy Reau, MD, and Kimberly Brown, MD, are joined by guest Jessica Mellinger, MD, to discuss rising prevalence, new care models, and evolving concepts in alcohol-associated liver disease (ALD).Key episode timestamps:0:00:00 – Introduction0:00:30 – Prevalence of alcohol use & ALD under-recognition0:04:22 – Origin and design of the integrated ALD clinic0:06:50 – Expansion and outcomes of integrated care0:10:33 – Workforce and access challenges0:12:21 – Metabolic ALD (MetALD) concept0:15:18 – GLP‑1 agonists for metabolic disease & AUD0:19:09 – “Food noise,” food addiction, and ultra‑processed foods0:22:38 – Liver transplantation in ALD & Dallas criteria0:27:27 – Outcomes after relapse & closing

In this episode of Liver Lineup: Updates & Unfiltered Insights, host Nancy Reau, MD, sits down with Kris Kowdley, MD, to discuss evolving approaches in cholestatic liver disease, with a particular focus on primary biliary cholangitis (PBC).Key episode timestamps:0:00:00 – Guest intro & evolution of PBC therapy0:07:34 – Redefining biochemical response & earlier assessment0:16:26 – OCA withdrawal & positioning PPARs/fibrates0:22:16 – Diagnosing AMA‑negative PBC0:25:58 – Genetic cholestasis panels & PFIC spectrum0:29:45 – Symptom burden, pruritus, & IBAT inhibitors0:35:17 – Bone health & closing remarks

In this episode of Liver Lineup: Updates and Unfiltered Insights, hosts Nancy Reau, MD, and Kimberly Brown, MD, sit down with Mary (Maru) Rinella, MD, a professor of medicine and director of Clinical Trials and the Metabolic and Fatty Liver Program at the University of Chicago, to discuss the rapidly evolving therapeutic landscape for metabolic dysfunction-associated steatohepatitis (MASH).Key Episode Timestamps:0:00:00 – Introduction & guest bio0:01:02 – Current therapy landscape & GLP‑1 overview0:03:51 – Do GLP‑1s help non–weight losers?0:05:21 – Combining GLP‑1s and resmetirom0:07:23 – Pipeline GLP‑1 combinations & phase 2 data0:09:26 – Advanced disease, sarcopenia & risk–benefit in cirrhosis0:13:29 – Introduction to FGF‑21 agonists0:14:04 – Symmetry (efruxifermin) trial & reading the data0:17:51 – Endpoints, “lack of progression,” and FDA hurdles0:19:41 – Need for non‑invasive surrogates0:21:02 – FGF‑21 mechanism & other liver diseases0:22:57 – Alcohol intake, GLP‑1s, FGF‑21 & MetALD0:25:49 – 10‑year outlook & future toolbox0:27:35 – Closing

Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let’s dive into the latest updates impacting clinicians and healthcare providers like you!Interested in a more traditional, text rundown? Check out the HCPFive!Top 5 Healthcare Headlines for January 18-24, 2025:1. Phase 2 Data Show NS002 Intranasal Epinephrine Acts Faster Than EpiPenInterim phase 2 data suggest NS002 intranasal epinephrine may provide more rapid systemic exposure than intramuscular autoinjectors, supporting its potential as a needle-free option for anaphylaxis management.2. AHA 2026 Heart Disease and Stroke Statistics: Progress and Pitfalls, With Latha Palaniappan, MD, MSThe AHA’s 2026 Heart Disease and Stroke Statistics highlight persistent gaps in cardiovascular prevention and outcomes despite advances in treatment, with continued emphasis on heart disease and stroke as leading causes of mortality in the US.3. New CHEST Recommendations Guide Biologic Use for Severe AsthmaCHEST released updated guidance to help clinicians individualize biologic selection for severe asthma based on patient characteristics, disease phenotype, and available evidence.4. Topical Steroid Concerns in Dermatology Highlighted in Nationwide SurveyA nationwide survey underscores widespread patient and caregiver concerns about long-term topical steroid use in chronic inflammatory skin diseases and a perception that current management strategies are largely reactive rather than preventive.5. Amlitelimab Effective, Safe for Atopic Dermatitis in Patients 12 Years and OlderPhase 3 data show amlitelimab was effective and well tolerated in adolescents and adults with moderate-to-severe atopic dermatitis, supporting its role as a targeted, non–T-cell-depleting biologic option.