Trial reportQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2026
Patients with MASH experience worse health-related quality of life: a multinational real-world study using LiverMultiScan.
Trial report in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePrevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), is increasing globally. Assessment of health-related quality of life (HRQoL), alongside non-invasive tests (NITs), may support identification of patients requiring closer clinical management. This multinational real-world randomised controlled trial evaluated associations between HRQoL (using the EQ-5D) and multiparametric MRI (mpMRI) markers of liver disease.
methodsRADIcAL-1 included 802 patients (453 male) with suspected MASLD/MASH from Germany, Netherlands, Portugal and UK. Participants completed the EQ-5D-5 L at baseline, 2, 6 and 12-months. EQ-VAS was derived to assess overall health. Between-group comparisons (imaging vs. standard-of-care) were assessed using t-tests, and multivariable logistic regression adjusted for age, obesity, diabetes and hyperlipidaemia. MASH was defined as corrected T1 (cT1) ≥800ms and liver fat as proton density fat fraction (PDFF) ≥ 10%. High-risk MASH was cT1 ≥ 875ms.
resultsWithin the imaging arm, patients with MASH reported lower HRQoL across all EQ-5D dimensions and EQ-VAS compared with MASLD. Baseline utilities ranged from 0.81 (Coimbra) to 0.90 (Ulm) and this range decreased at month 12 from 0.82 (Coimbra and UK) to 0.90 (Ulm). These findings remained after adjustment for comorbidities. Patients with high-risk MASH reported up to 12% more complaints in all EQ-5D dimensions compared to all others. Increasing cT1 was associated with 29% higher odds of reporting anxiety/depression. An 80ms increase in cT1 was associated with 0.023-point decrease in EQ-5D utility (p = 0.039). Due to COVID-19, 12-month response rates varied across sites (22-81%).
conclusionmpMRI-defined MASH is associated with worse HRQoL independent of key metabolic comorbidities. These findings support the use of imaging biomarkers for disease stratification and for identifying patients with greater clinical burden, with potential implications for management and monitoring strategies.
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