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Alcohol-related liver disease is one of the world’s major public health problems. Every year, more than 20 million new cases of alcohol-related cirrhosis are diagnosed, resulting in over 330,000 deaths worldwide. Yet, despite its scale, research into alcohol-related liver disease remains both underprioritised and underfunded.

Stine Johansen’s interest in this field began when, as a medical student, she completed a clinical placement in a liver outpatient clinic at Odense University Hospital.

“I really like working with patients who have alcohol-related liver disease because they are a somewhat overlooked group that faces a lot of stigma — from themselves, from society, and even from healthcare professionals. That’s unfortunate, because stigma can prevent people from seeking help. I want to be part of changing that,” says Stine Johansen, who has been awarded the Lundbeck Foundation Talent Prize 2025 for her research on alcohol-related liver disease.

Vulnerable patients

Stine Johansen has gone above and beyond to ensure that vulnerable patients can take part in her studies.

“Some patients need a bit of extra help to make things work, because they are fragile. Sometimes I go and pick them up and take them to the hospital myself. Other times, I’ve done a scan and taken blood samples in their homes,” she explains.

“It’s crucial that patients have a positive experience participating in research. I find that most patients actually want to take part, but some just don’t have the resources to make it to the hospital on their own.”

Early diagnosis with fibro scanning

Stine Johansen’s research focuses particularly on non-invasive methods for diagnosing alcohol-related liver disease early in its course — before patients develop decompensated cirrhosis — so that they can be offered alcohol cessation treatment and specialist care in time.

Copyright/photographer

Pexel

Non-invasive methods include blood tests and fibro scanning examinations, which estimate the amount of fibrosis (scar tissue) in the liver.

“We have tested these methods both as diagnostic tools and as ways to predict which individuals are at risk of developing liver disease in the future. We can also use them for monitoring — for example, performing a fibro scanning once a year in patients with liver disease,”
says Stine Johansen.

The alternative to non-invasive methods is a liver biopsy, which is used to assess the degree of fibrosis in the liver but is both resource-intensive and uncomfortable for patients.

First drug for alcohol-related liver fibrosis

Currently, there is no approved treatment for alcohol-related liver fibrosis — the formation of scar tissue in the liver caused by alcohol. However, Stine Johansen contributed to the first clinical trial testing a potential drug for this condition.

“In our studies, we were the first to demonstrate that the drug rifaximin can slow the progression of liver fibrosis in patients with alcohol-related liver disease,” says Stine Johansen.

“There has long been a perception that drug trials in this patient group are not feasible, as it can be too demanding for patients to adhere to the treatment. However, we demonstrated that it is indeed possible.”

A major multicentre study ahead

Stine Johansen is now beginning a PhD project, which will continue into a postdoctoral fellowship, where she will serve as day-to-day coordinator of a large-scale liver disease screening study.

A total of 100,000 participants will be included from six countries: Denmark, Germany, Slovakia, Croatia, Italy, and Spain.

Half of the participants will undergo screening for liver disease. If early signs of liver disease are detected, these individuals will receive treatment aimed at preventing progression to severe liver disease. All participants will be followed for ten years, after which the researchers will analyse data to compare mortality and hospitalisations for cirrhosis between the screened-and-treated group and the control group living a “normal” life without screening.

“It’s incredibly exciting — it’s a large study with the right design, and it will provide new knowledge about whether population-wide screening for liver disease would be worthwhile in the future, similar to today’s screening programmes for breast cancer,” says Stine Johansen.

Research is a team effort

Stine Johansen has no doubt about how she will use her Talent Prize funds:

“I want to take my research abroad and experience another research environment. I’ll also use part of the prize to benefit my entire research group — to give something back. Because research really is a collective effort,” she says.