---
title: >-
  Sustained Elevation in Alkaline Phosphatase is Associated with Greater Disease
  Severity in Real World NAFLD in TARGET-NASH.
description: >-
  Explore this publication on real-world evidence: Sustained Elevation in
  Alkaline Phosphatase is Associated with Greater Disease Severity in Real World
  NAFLD…
date: '2017-01-01'
category: Publications
tags:
  - DDW
  - Poster Presentation
  - Approval / Commercialization
  - Care
  - Hepatology
  - MASH/MASLD
  - Health System Partner
canonical_url: >-
  https://www.pedestalhealth.com/resources/publications/ddw/sustained-elevation-in-alkaline-phosphatase-is-associated/
source: Pedestal Health
license: © 2026 Pedestal Health. All rights reserved.
slug: sustained-elevation-in-alkaline-phosphatase-is-associated
id: 5VqdbphH6cNZGrRAMUw4Fk
contentType: article
---

## Challenge

Sustained alkaline phosphatase elevation in NAFLD is recognized as a marker of cholestatic injury and advanced disease, but its independent association with disease severity outcomes in a large real-world cohort had not been established, limiting its utility as a monitoring biomarker.

## Solution

The TARGET-NASH cohort was analyzed to compare clinical characteristics and outcomes between patients with sustained ALP elevation (≥2 consecutive values >1.5x ULN) versus non-elevated ALP, stratified by disease severity, characterizing the association between sustained ALP elevation and decompensation events.

## Impact

Establishing that sustained ALP elevation is independently associated with higher MELD scores and decompensation events in NAFLD cirrhosis provides evidence for ALP as a monitoring biomarker and supports its inclusion in composite safety and outcome endpoints in advanced NAFLD studies.