Analysis of discrimination and calibration of two cardiovascular risk scores in patients with non-alcoholic steatohepatitis shows a need for improved accuracy of these models.

Challenge

Cardiovascular risk assessment tools like the Framingham Risk Score and Pooled Cohort Equations were developed in general populations and may not accurately predict CV events in NAFLD/NASH patients, who have distinct metabolic risk profiles.

Solution

Target RWE and Madrigal Pharmaceuticals researchers analyzed TARGET-NASH data to evaluate the discrimination and calibration of Framingham and PCE risk equations in NAFLD/NASH patients, finding poor predictive accuracy and systematic overestimation.

Impact

Establishing that standard CV risk tools perform poorly in NAFLD/NASH patients creates the evidence foundation for developing NASH-specific cardiovascular risk models, directly supporting Madrigal's commercial strategy for resmetirom.