SynthesisLiver international : official journal of the International Association for the Study of the Liver2026
Progression to Decompensation of Severe Fibrosis Compared to Cirrhosis in MASLD: A Systematic Review and Meta-Analysis.
Synthesis in Liver international : official journal of the International Association for the Study of the Liver, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Progression to Decompensation of Severe Fibrosis Compared to Cirrhosis in MASLD: A Systematic Review and Meta-Analysis.Liver international : official journal of the International Association for the Study of the Liver · 2026Pooled it
- Chronic infection and metabolic stress: a converging axis driving hypertension and metabolic dysfunction-associated steatotic liver disease outcomes.American journal of hypertension · 2026Review
- Review
- Non-Invasive Tests for the Detection of MASLD: Biomarkers and Imaging for Staging Steatosis, MASH, and Fibrosis.International journal of general medicine · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsMetabolic associated steatotic liver disease (MASLD) is increasing in prevalence worldwide. Clinical practice is focused on identifying those with cirrhosis and monitoring for complications such as varices and hepatocellular carcinoma (HCC). Non-invasive tests of fibrosis differentiate between F3 and F4 fibrosis poorly. People with F3 fibrosis may progress and develop decompensated liver disease. The aim of this review is to examine the progression to decompensated liver disease in patients with F3 fibrosis compared to those with F4 fibrosis.
methodsSearches were carried out in four databases; articles were screened by two independent reviewers against pre-specified inclusion and exclusion criteria.
resultsTwenty-nine studies were included in the review: 12 with paired liver biopsies, 2 progression to cirrhosis, 13 progression to decompensation, 2 portal hypertension in F3 fibrosis and 13 on HCC in F3 fibrosis. Rates of progression on paired biopsies were 16%-30% over varied follow-up. Varices were found in 16% of patients with F3 fibrosis and rates of non-cirrhotic HCC varied from 37%-75%. Pooled univariate HR for F3 progression and F4 progression to major adverse liver outcomes (MALO) were 8.15 (95% CI 3.42-19.43) and 38.16 (95% CI 11.58-125.76), respectively.
conclusionsProgression to cirrhosis and decompensation events occurs in a significant proportion of patients with F3 fibrosis in MASLD. There is evidence of portal hypertension and HCC developing in F3 MASLD. Further work to identify risk groups, including those at risk of rapid progression to guide future clinical management is urgently required given the prognostic inflection of decompensated disease.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.