Ongoing research projects:
Opportunistic treatment of hepatitis C (OPPORTUNI-C)
Investigator-initiated, pragmatic, open-label, multicenter, stepped wedge cluster randomized trial recruiting HCV RNA positive individuals admitted for inpatient care in departments of internal medicine, addiction medicine, and psychiatry at Oslo University Hospital, Akershus University Hospital, and Lovisenberg Diaconal Hospital. The main aim is to evaluate the efficacy of opportunistic HCV treatment compared to a referral-based standard of care. The clinical trial has recently been completed and follow-up studies on reinfection incidence and antiviral resistance are ongoing. The project is led by Håvard Midgard and Olav Dalgard and is a part of Kristian Malme’s PhD project. The study was funded by South-Eastern Norway Regional Health Authority.
Low-threshold models of hepatitis C care
A series of observational studies of HCV treatment models for people who inject drugs conducted in collaboration with Centre for Elimination of Hepatitis (SELIHEP). The low-threshold HCV clinic in downtown Oslo is a nurse-led ambulant service providing HCV care for the most marginalized patients. Real-world data from the first seven years of the clinic was recently published. The Hepatitis Bus is a peer-led mobile clinic providing HCV care across Norway with financial support provided by the Norwegian Directorate of Health. Results from the first year of operation was published in Liver International. In addition, registry-based epidemiological studies on treatment uptake and documentation of HCV elimination in Norway are ongoing.
Natural disease course, prognostic factors, and biomarkers for disease activity in Autoimmune Liver Diseases (AIL)
Prospective multicenter study led from the Norwegian PSC Center recruiting outpatients with autoimmune liver diseases across Norway. The main aim is to establish a population-based cohort of patients for prospective data collection and biobanking, providing a platform to study the natural course of disease including patient-reported outcomes, prognostic factors, and biomarkers for disease activity in primary sclerosing cholangitis, primary biliary cholangitis, and autoimmune hepatitis.
Proactive case-finding and early detection of liver disease among hospitalized people with harmful alcohol consumption (PREDILECTION)
Investigator-initiated, pragmatic, open-label, multicenter, individual-randomized controlled trial recruiting inpatients from ten Norwegian hospitals. The overall aim is to improve early detection of liver disease among people with harmful alcohol use and thereby prevent disease burden. The project will 1) evaluate the efficacy of proactive elastography-based liver disease assessment and brief alcohol intervention among hospitalized people with harmful alcohol consumption, 2) assess the prognostic and predictive performance of a panel of serum biomarkers, and 3) evaluate the cost-effectiveness of the intervention.
Non-invasive methods for detection of liver fibrosis, inflammation, and steatosis
Prospective observational study assessing the diagnostic accuracy of transient elastography (FibroScan), 2D-shear-wave elastography, and MR elastography for detection of liver fibrosis and prediction of liver-related events. The study will also evaluate novel non-invasive tests such as shear wave dispersion and attenuation imaging.
Surveillance of hepatocellular carcinoma
This observational study aims to describe the epidemiology, treatment, and prognosis of hepatocellular carcinoma among consecutive outpatients. In particular, the effect of six-monthly ultrasound surveillance will be evaluated.
Outcomes of treatment with Transjugular Intrahepatic Portosystemic Shunts (TIPS)
Retrospective cohort study documenting clinical experience with TIPS for treatment of gastroesophageal variceal bleeding and refractory ascites at Oslo University Hospital Ullevål.
Semaglutide in non-alcoholic steatohepatitis (ESSENCE)
Industry-initiated international phase 3 study recruiting subjects with non-cirrhotic MASLD (NASH) to evaluate the efficacy of high dose semaglutide vs placebo on histological endpoints.
Cirrhosis-registry
Prospective registry including consecutive outpatients with compensated and decompensated advanced chronic liver disease of all etiologies.