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ADAPT and VCTE show comparable performance for identifying MASH patients with significant fibrosis
August 28, 2026
ADAPT and VCTE show comparable performance for identifying MASH patients with significant fibrosis: Implications for selecting patients eligible for therapy
Introduction
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of liver-related morbidity and mortality, with fibrosis stage being the strongest predictor of adverse outcomes. Following the recent approval of pharmacological therapies for metabolic dysfunction–associated steatohepatitis (MASH) in patients with moderate fibrosis (F2–F3) without cirrhosis (F4), there is an urgent need for reliable non-invasive tests (NITs) to identify patients eligible for therapy. The ADAPT algorithm, incorporating the serum biomarker PRO-C3, along with platelets, age, and diabetes status, has recently transitioned to the Roche Cobas® e801 high throughout IVD analyzer.
This study evaluated the diagnostic performance of two well-established NITs for fibrosis assessment – the PRO-C3-based ADAPT algorithm and vibration-controlled transient elastography (VCTE) for identifying F2-3, F3-4 or F4 patients in a Danish prospective outpatient cohort.
Poster
Conclusion
ADAPT and VCTE performed similarly in detecting F2-F3, F3-4 fibrosis or F4 cirrhosis, one being blood-based and the other imaging-based. As many F2-F3 cases are missed, this indicates a large number of patients may be left untreated using only one text. These findings support further investigating of NITs for non-invasive fibrosis assessment and for identifying patients eligible for MASH therapy.
