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Iyer JS, Pokkalla H, Biddle-Snead C, Carrasco-Zevallos O, Lin M, Shanis Z, Le Q, Juyal D, Pouryahya M, Pedawi A, Hoffman S, Elliott H, Leidal K, Myers RP, Chung C, Billin AN, Watkins TR, Resnick M, Wack K, Glickman J, Burt AD, Loomba R, Sanyal AJ, Montalto MC, Beck AH, Taylor-Weiner A, Wapinski I. AI-based histologic scoring enables automated and reproducible assessment of enrollment criteria and endpoints in NASH clinical trials. medRxiv 2023:2023.04.20.23288534. [PMID: 37162870 PMCID: PMC10168404 DOI: 10.1101/2023.04.20.23288534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Clinical trials in nonalcoholic steatohepatitis (NASH) require histologic scoring for assessment of inclusion criteria and endpoints. However, guidelines for scoring key features have led to variability in interpretation, impacting clinical trial outcomes. We developed an artificial intelligence (AI)-based measurement (AIM) tool for scoring NASH histology (AIM-NASH). AIM-NASH predictions for NASH Clinical Research Network (CRN) grades of necroinflammation and stages of fibrosis aligned with expert consensus scores and were reproducible. Continuous scores produced by AIM-NASH for key histological features of NASH correlated with mean pathologist scores and with noninvasive biomarkers and strongly predicted patient outcomes. In a retrospective analysis of the ATLAS trial, previously unmet pathological endpoints were met when scored by the AIM-NASH algorithm alone. Overall, these results suggest that AIM-NASH may assist pathologists in histologic review of NASH clinical trials, reducing inter-rater variability on trial outcomes and offering a more sensitive and reproducible measure of patient therapeutic response.
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Affiliation(s)
| | | | | | - Oscar Carrasco-Zevallos
- PathAI, Boston, MA, USA
- Affiliation shown is that during the time of study; current affiliation is Johnson & Johnson, New Brunswick, NJ, USA
| | | | | | | | | | - Maryam Pouryahya
- PathAI, Boston, MA, USA
- Affiliation shown is that during the time of study; current affiliation is AstraZeneca, Gaithersburg, MD, USA
| | - Aryan Pedawi
- PathAI, Boston, MA, USA
- Affiliation shown is that during the time of study; current affiliation is Atomwise, San Francisco, CA, USA
| | | | - Hunter Elliott
- PathAI, Boston, MA, USA
- Affiliation shown is that during the time of study; current affiliation is BigHat Biosciences, San Mateo, CA, USA
| | - Kenneth Leidal
- PathAI, Boston, MA, USA
- Affiliation shown is that during the time of study; current affiliation is Genesis Therapeutics, Burlingame, CA, USA
| | - Robert P. Myers
- Gilead Sciences, Inc., Foster City, CA, USA
- Affiliation shown is that during the time of study; current affiliation is OrsoBio, Inc., Palo Alto, CA, USA
| | - Chuhan Chung
- Gilead Sciences, Inc., Foster City, CA, USA
- Affiliation shown is that during the time of study; current affiliation is Inipharm, San Diego, CA, USA
| | | | | | - Murray Resnick
- PathAI, Boston, MA, USA
- Affiliation shown is that during the time of study; current affiliation is Rhode Island Hospital and The Miriam Hospital, Providence, RI, USA
| | | | | | | | - Rohit Loomba
- NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, San Diego, CA, USA
| | - Arun J. Sanyal
- Stravitz-Sanyal Institute for Liver Disease and Metabolic Health, VCU School of Medicine, Richmond, VA, USA
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