Gawrieh S, Harlow KE, Pike F, et al. - In children who took part in the TONIC trial, enhanced liver fibrosis score (ELF) was linked to the fibrosis stage. A decrease in ELF at end of treatment (EOT) was associated with NASH resolution and improvement in NAFLD histology, but not with fibrosis improvement. ELF could be a good non-invasive way to track how well children with NAFLD are responding to treatment.

• On sera from 166 TONIC participants, ELF was evaluated at baseline, weeks 24, 48, and 96.

• At both baseline and EOT, ELF was found to be linked with the severity of fibrosis.

• For distinguishing individuals with clinically significant and advanced fibrosis, the ELF areas under the curve were 0.70 and 0.79, respectively.

• Overall histological improvement, resolution of steatohepatitis, improvement in steatosis grade, and hepatocellular ballooning were all linked with a one-unit decline in ELF at EOT, but not with improvement in the fibrosis stage.