---
title: "Fatty liver in lean patients and five other research briefs"
id: "bmj-2-leaning-into-fatty-liver-findings-and-other-research"
canonical_url: "https://medichelpline.com/clinical-feed/bmj-2-leaning-into-fatty-liver-findings-and-other-research"
content_type: "clinical_feed_article"
specialty: "Gastroenterology"
source_name: "BMJ"
source_url: "http://www.bmj.com/content/395/bmj-2026-101115.short?rss=1"
published_at: "2026-10-22T09:21:07.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Fatty liver in lean patients and five other research briefs
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-2-leaning-into-fatty-liver-findings-and-other-research
- **Specialty:** [Gastroenterology](https://medichelpline.com/clinical-feed/gastroenterology.md)
- **Primary Source:** BMJ
- **Source URL:** [Original Journal Publication](http://www.bmj.com/content/395/bmj-2026-101115.short?rss=1)
- **Published At:** 2026-10-22T09:21:07.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- A double blind crossover trial randomly allocated **134** adolescents and adults with hereditary angioedema to receive either **deucrictibant** or placebo during attacks; time to onset of symptom relief was much shorter with deucrictibant (median 1.28 hours, 95% CI 1.05–1.52) than with placebo (median >5.82 to >12 hours), investigators reported. - An optogenetic intravitreal gene therapy delivered by viral vector made ganglion cells light sensitive; wearing specialised goggles, six of ten participants had a clinically meaningful increase in light sensitivity, the study team observed. The authors noted these changes do not equal restoration of normal vision but do show induced light sensitivity in retinal cells. - A phase 3 study of oral **nicotinamide riboside** versus placebo in early Parkinson’s disease found worse motor and non-motor outcomes in the treatment arm at 52 weeks, the trial investigators reported. - A retrospective observational study of adults with biopsy confirmed metabolic dysfunction-associated steatotic liver disease (MASLD) examined outcomes in people with **lean MASLD** versus MASLD with obesity; data indicated similar mortality and clinical outcomes between groups, and the severity of fibrosis emerged as the main prognostic factor, authors noted. - A global survey of self-reported pain collected data from over six million people across 118 countries; the cohort showed estimated prevalence of facial pain around 2% and back pain around 40%, with headache prevalence peaking in the mid-30s and back pain increasing with age. Researchers attributed 18.3% of the pain burden to three modifiable risk factors: smoking, obesity, and low income. - Footnotes: competing interests were declared as none; the BMJ article was not externally peer reviewed and was not commissioned, as the author reported.
## Clinical Analysis & Structured Key Points
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[News & Views](https://www.bmj.com/us/news) 2. Leaning into fatty... 3. Leaning into fatty liver findings . . . and other research Opinion # Leaning into fatty liver findings . . . and other research BMJ 2026; 395 doi: (Published 22 October 2026) Cite this as: BMJ 2026;395:e101115 * [Article](https://www.bmj.com/content/395/bmj-2026-101115 "Article Tab - Article")[](https://www.bmj.com/panels_ajax_tab/jnl_bmj_tab_art/node:1129232/1 "Article Tab - Article") * [Related content](https://www.bmj.com/content/395/bmj-2026-101115/related "Article Tab - Related Articles")[](https://www.bmj.com/panels_ajax_tab/jnl_bmj_tab_related_art/node:1129232/1 "Article Tab - Related Articles") * [Metrics](https://www.bmj.com/content/395/bmj-2026-101115/article-info "Article Tab - Info & Metrics")[](https://www.bmj.com/panels_ajax_tab/jnl_bmj_tab_info/node:1129232/1 "Article Tab - Info & Metrics") * [Responses](https://www.bmj.com/content/395/bmj-2026-101115/rapid-responses "BMJ Article Related Rapid Responses")[](https://www.bmj.com/panels_ajax_tab/bmj_related_rapid_responses/node:1129232/1 "BMJ Article Related Rapid Responses") * [Peer review](https://www.bmj.com/content/395/bmj-2026-101115/peer-review "Article Tab - Peer review")[](https://www.bmj.com/panels_ajax_tab/jnl_bmj_tab_peer_review/node:1129232/1 "Article Tab - Peer review") * [](https://www.bmj.com/content/395/bmj-2026-101115/submit-a-rapid-response "BMJ Rapid Responses Form")[](https://www.bmj.com/panels_ajax_tab/bmj_rapid_responses_form/node:1129232/1 "BMJ Rapid Responses Form") ![Loading](https://www.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif) 1. Tom Nolan, clinical editor; sessional GP, Surrey [Author affiliations](https://www.bmj.com/content/395/bmj-2026-101115.short?rss=1) 1. _The BMJ_ , London Tom Nolan reviews this week’s research ## Symptom relief in hereditary angioedema Symptoms of hereditary angioedema can be easily mistaken for allergy. Hereditary angioedema tends to present with episodes of angioedema without urticaria, abdominal pain is often present, and antihistamines tend to be ineffective. Findings from a trial of deucrictibant, offer hope that the oral bradykinin B2 receptor antagonist could become a useful therapy. Researchers randomly allocated 134 adolescents and adults with hereditary angioedema as part of a double blind crossover trial, where participants received either deucrictibant or placebo during attacks. Time to onset of symptom relief was much shorter when participants took deucrictibant for an episode (median time 1.28 hours, 95% confidence interval 1.05 to 1.52) compared with more than 12 hours with placebo (5.82 to >12). _Lancet_ doi:[10.1016/S0140-6736(26)01296-1](https://www.bmj.com/lookup/doi/10.1016/S0140-6736\(26\)01296-1) ## Light ahead for treatment of retinitis pigmentosa The _New England Journal of Medicine_ publishes findings from a study of a groundbreaking new treatment for blindness in people with retinitis pigmentosa. The optogenic therapy involved intravitreal administration of a viral vector that delivers a gene to ganglion cells in the eye to make them light sensitive. Wearing special goggles, six out of 10 participants in the study had a clinically meaningful increase in light sensitivity with the treatment. Although these improvements aren’t the same as bringing back normal vision, the study shows that cells in the eye can be made light sensitive, opening up new possibilities for optogenic treatments of blindness. _N Engl J Med_ doi:[10.1056/NEJMoa2602215](https://www.bmj.com/lookup/doi/10.1056/NEJMoa2602215) ## No benefit found from nicotinamide riboside in Parkinson’s disease Promising early studies do not always translate into clinical benefit, as a trial of nicotinamide riboside for Parkinson’s disease shows. Boosting levels of the vitamin B3 related compound aimed to improve mitochondrial function and protect neurons from oxidative stress. A phase 3 study of oral nicotinamide riboside versus placebo in people with early Parkinson’s disease found that symptoms were worse in the treatment arm after 52 weeks compared with placebo. Rates of non-motor symptoms were also higher in the nicotinamide riboside group. _JAMA_ doi:[10.1001/jama.2026.18828](https://www.bmj.com/lookup/doi/10.1001/jama.2026.18828) ## Leaning into fatty liver findings On most days in most GP practices at least one ultrasound report lands in the results queue with an incidental finding of a fatty liver. What this means for the patient, aside from more lifestyle advice to lose weight, is usually hard to work out without further investigations. Adding to the confusion is a retrospective observational study of adults with biopsy confirmed metabolic dysfunction-associated steatotic liver disease (MASLD). It found that people with lean MASLD—fatty liver with a normal body mass index (BMI)—had similar mortality rates and clinical outcomes as those with MASLD and obesity. Severity of fibrosis was the main factor that was associated with prognosis. _JAMA_ doi:[10.1001/jama.2026.18491](https://www.bmj.com/lookup/doi/10.1001/jama.2026.18491) ## The age of pain One aspect of clinical reasoning that seemed to help things to eventually click was developing a sense of how common various symptoms are among the general population. A study that gathered self reported pain data from over six million people across 118 countries offers some helpful insights. Prevalence of facial pain is estimated at around 2%, with back pain at 40%. Headache prevalence peaks in people’s mid-30s, whereas back pain just seems to get more and more common as populations get older. The researchers attributed 18.3% of pain burden to three modifiable risk factors: smoking, obesity, and low income. _Nat Med_ doi:[10.1038/s41591-026-04696-w](https://www.bmj.com/lookup/doi/10.1038/s41591-026-04696-w) ## Footnotes * Competing interests: none declared. * Provenance and peer review: not commissioned; not externally peer reviewed. * [Tweet Widget](http://twitter.com/share?url=https%3A//www.bmj.com/content/395/bmj-2026-101115&count=horizontal&via=&text=Leaning%20into%20fatty%20liver%20findings%20.%20.%20.%20and%20other%20research&counturl=www.bmj.com/content/395/bmj-2026-101115 "Tweet This") ## Article tools [PDF](https://www.bmj.com/content/395/bmj-2026-101115.full.pdf "PDF")[0 responses](https://www.bmj.com/content/395/bmj-2026-101115/rapid-responses) * [Respond to this article](https://www.bmj.com/content/395/bmj-2026-101115/submit-a-rapid-response) * [Print](https://www.bmj.com/content/395/bmj-2026-101115.full-text.print) * [Alerts & updates](https://www.bmj.com/#mini-panel-jnl-bmj-article-page-alerts-1) #### Article alerts Please note: your email address is provided to the journal, which may use this information for marketing purposes. #### Log in or register: Username * Password * [Register for alerts](https://myaccount.bmj.com/myaccount/registration.html?regService=bmj-registration&fwdUrl=https://www.bmj.com/content/395/bmj-2026-101115?tab=article-alert&itemId=pr1906) If you have registered for alerts, you should use your registered email address as your username * [Citation tools](https://www.bmj.com/#mini-panel-article-page-citation-download-1) #### Download this article to citation manager Tom Nolan clinical editor; sessional GP, Surrey Nolan T. 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