Can you give me an introduction to your clinical practice and research interests?

Great. I just want to kick this off by understanding a bit more about AH. There was a 2018 article publishedby Dr. Emily Hughes about survival from alcholic hepatitis. They looked at 77 studies published between 1971 and 2016 and concluded that overall mortality from AH was 26% at 28 days, 29% at 90 days, and 44% at 180 days after hospital admission. These numbers are pretty stunning to me and I had no idea they were so high. Is thatpretty aligned with what you see in your practice?

I want to understand what the typical admission looks like. Like, how much of it is after a severe binging episode vs long term alcohol use. And what would you say drives patients to be admitted, is it acute jaundice or something else?

What % of patients who are admitted would you classify as severe vs moderate/mild (mdf >32)

Since Covid, have you found the admissions to increase, or is it about the same

After a patient is admitted, how do you make the diagnosis? Usually through biopsy?

I want to get an idea of how patients are treated, in particular, how many end up on corticosteroids or liver transplants, ECAD, plasmapheresis

Moving onto larsucosterol, for the inclusion criteria, they are enrolling patients with MDF scores >32 and MELD scores between 21 and 30, which to my understanding is pretty severe. What 90 day mortality would you expect in that general population based on that criteria?

Do you believe there are patient characteristics which yield better outcomes? Like age, overall health, sex, ethnicity, smokers, etc?

In the phase 2a trial they showed 100% survival for an open label, with a n of 19, with 12 of those being severe. All of them survived, with 8 of those 12 severe patients being discharged in 4 days or less after a single dose. Lille score was 0.19. So obviously this data is inherently limited by its open label nature and small n, but what are your thoughts about these results? Can you think of any other reasons all the patients may have recovered?

What do you make of the epigenetic mechanism? Do you find it concerning that this mechanism hasn't been published on in well-known medical journals, to my knowledge?

Assuming the drug did work, is there a % survival at 90 days you would like to see before you use it, or would you just try to put a patient on it as long as it is stat sig over placebo given lack of options?

Would you consider using it in all comers, off-label, or would you keep it to severe AH patients?

Something I found interesting was that bilirubin > 8 mg/dL had a median reduction over 28 days by nearly 50%. Is this something that happens naturally in terms of normal recovery?

Overall, how optimistic are you that this drug actually has activity in this indication, given the small n?