£800k grant awarded to find undiagnosed liver disease patients in UK health system using precision medicine

Grants totalling £800k have been awarded by Innovate UK to a group of applicants aiming to develop and test a system to identify undiagnosed, high-risk liver disease in patient populations.

Sano Genetics, a Cambridge-based company that accelerates precision medicine research, will work alongside Predictive Health Intelligence and Somerset NHS Foundation Trust, which have developed a novel approach to identify high-risk liver disease cases from common blood tests already present in NHS databases. The team will be collaborating with Tawazun Health, specialists in mobile non-invasive liver scanning technology.

By combining longitudinal biomarker analysis, non-invasive liver scanning, and non-invasive genetic testing, they will identify cases far earlier than existing approaches with a particular focus on early-onset and fast-progressing liver disease. Key to this project is that as many as 30% of the adult population will have markers of fatty liver disease, so a highly selective approach to identifying those at risk of progression is needed.

Identified at-risk patients will receive letters inviting them to be scanned, and to do an at-home DNA test using a simple kit supplied by Sano Genetics, which will also sequence their genetic data. Standard follow up treatment plans and counselling will be offered to patients, as well as free access to Sano’s patient engagement platform. Additional NHS Trust partners will be added and announced as the project progresses.

Earlier diagnosis for non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) is urgent. These conditions – associated with obesity and type 2 diabetes, and which can lead to serious liver damage, including cirrhosis and liver cancer as well as a reduced life expectancy – are increasingly prevalent in the UK, with an estimated one in three adults affected. Liver disease is now the second leading cause of death among 35-49 year olds.

However, NAFLD and NASH present late and are often asymptomatic, meaning patients may not be diagnosed until the disease has progressed to a more serious stage. This increases the complexity and cost of treatment, as well as reducing the effectiveness of interventions, forcing up the cost of treating liver disease, and putting a significant strain on NHS resources.

Patrick Short, CEO and co-founder of Sano Genetics, says: “Around one in every three UK adults are estimated to be living with a form of liver disease, yet diagnosis and awareness of NAFLD or NASH is low. Furthermore, genomics research has shown that genes such as PNPLA3 contribute greatly to earlier-onset and faster-progressing liver disease, and integrating genetic data with routine blood scans and non-invasive liver scanning will help identify patients in this category sooner. This pioneering programme could change the way we diagnose and treat liver disease for good. By combining genomics, non-invasive liver scanning, and machine-learning technologies that already exist, we can save lives as well as cost to the NHS.”

Tim Jobson, medical director of Predictive Health Intelligence says: “It’s time to end the late diagnosis of liver disease, which places a huge burden on the health of the nation and which accounts for 26,000 premature deaths and 100,000 years of lost life each year. Combining precision medicine with proven technologies has the potential to pave the way for national screening and risk-stratification for liver and metabolic disease. This cannot come soon enough.”

Louise Campbell, founder and clinical director of Tawazun Health, says: “This is an important and urgently needed project. The majority of patients with liver disease are diagnosed too late for effective intervention or treatment, so improving early detection – through this joined-up, non-invasive approach – is critical. We’re pleased to be assisting with the delivery of Fibroscanning services enabling a greater level of consistency and efficiency.”

About the grant co-applicants:
Sano Genetics helps precision medicine clinical operations teams accelerate trials by combining at-home genetic testing, recruitment, and long-term patient engagement all in one place, for faster enrollment and simplified operations. It can find hard-to-reach patients 10x faster at 5x lower cost. https://sponsors.sanogenetics.com

Predictive Health Intelligence, a pioneering partnership between NHS leaders, healthcare information management, and clinical experts, has developed a case-finding search engine that uses existing data to make identifying patients at risk of liver disease straightforward and cost-effective. https://predictivehealthintelligence.co.uk

Somerset NHS Foundation Trust delivers acute, mental health and community services across Somerset. https://www.somersetft.nhs.uk

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