Liver cirrhosis is scarring of the liver caused by long-term damage from hepatitis, alcohol, fatty liver disease, or other conditions. About 4.5 million U.S. adults have cirrhosis. Treatment focuses on slowing progression, managing complications like fluid buildup and bleeding, and liver transplant when the liver fails.
What's actually going on in research
Trials are testing drugs to reduce scarring and reverse early fibrosis, new treatments for portal hypertension that causes bleeding and fluid buildup, and ways to prevent liver cancer in people with cirrhosis. Researchers are also studying metabolic therapies for fatty liver disease before it reaches cirrhosis, and artificial liver support devices as a bridge to transplant.
Anti-fibrotic drugs
Several drugs aim to reverse liver scarring rather than just slow it down. Early trials suggest some fibrosis can be reversible, which would fundamentally change how cirrhosis is treated.
Portal hypertension treatments
New drugs target the high blood pressure in the liver that causes dangerous bleeding and fluid buildup. These could prevent life-threatening complications without requiring procedures.
NASH-targeted therapies
Drugs like resmetirom, approved in 2024 for fatty liver disease, may prevent progression to cirrhosis. Trials are testing whether treating metabolic dysfunction can stop or reverse early liver damage.
What to know before you search
Eligibility typically depends on cirrhosis cause (alcohol, hepatitis C, fatty liver disease, etc.), severity measured by Child-Pugh or MELD score, presence of complications, and whether decompensation has occurred.
What types of trials are currently open
- Anti-fibrotic trials — Testing drugs that aim to reduce or reverse liver scarring. These often measure changes in liver stiffness and biopsy samples over months to years.
- Portal hypertension trials — Testing treatments to lower pressure in liver blood vessels, which can prevent bleeding from enlarged veins and reduce fluid buildup.
- Complication prevention trials — Studies of drugs or procedures to prevent specific cirrhosis complications like infections, kidney problems, or hepatic encephalopathy (confusion from liver dysfunction).
- Liver cancer screening studies — Testing better ways to detect liver cancer early in people with cirrhosis, when treatment is most effective.
- Registry studies — Long-term tracking of people with cirrhosis to understand disease progression, treatment outcomes, and factors that predict who will need transplant.
Recently added Liver Cirrhosis trials
Optimal Treatment Strategy for Spontaneous Bacterial Peritonitis
Spontaneous bacterial peritonitis (SBP) is a serious infection that occurs in patients with liver cirrhosis and ascites and is associated with substantial morbidity and mortality. Current clinical practice often includes follow-up paracentesis approximately 48 hours after starting antibiotic treatment to assess the change in the ascitic fluid polymorphonuclear leukocyte (PMN) count. However, it remains uncertain whether routine follow-up paracentesis improves clinical outcomes compared with a strategy based primarily on clinical response. This pilot randomized controlled trial will evaluate whether routine follow-up paracentesis is necessary in patients with cirrhosis and SBP. A total of 40 adult patients with SBP will be randomly assigned in a 1:1 ratio to either a routine follow-up paracentesis group or a no-routine follow-up paracentesis group. All participants will receive standard antibiotic therapy and intravenous albumin according to the study protocol. Participants assigned to the routine follow-up paracentesis group will undergo repeat paracentesis approximately 48 hours after initiation of antibiotic therapy. Ascitic fluid PMN counts and other laboratory findings will be assessed, and antibiotic treatment may be modified according to the treatment response. Participants assigned to the no-routine follow-up paracentesis group will be monitored using clinical symptoms, vital signs, and blood inflammatory markers without scheduled repeat paracentesis. However, paracentesis may be performed at any time if clinically indicated, such as in the presence of worsening abdominal symptoms, persistent fever, or hemodynamic instability. The study will compare clinical outcomes between the two treatment strategies, including 30-day and 90-day survival, treatment response, duration of antibiotic therapy, length of hospital stay, SBP recurrence, complications, new infections, and medical costs. The results of this pilot study are intended to provide preliminary evidence for determining whether routine follow-up paracentesis can be safely avoided in selected patients with SBP and to inform the design of a larger randomized controlled trial.
The Value of Spleen Thickness and Spleen Diameter for Gastroesophageal Varices Diagnosis in Compensated Cirrhosis
This retrospective cross-sectional diagnostic study compared the diagnostic performance of ultrasound-measured spleen thickness (ST) and spleen diameter (SD) against esophagogastroduodenoscopy (EGD) for gastroesophageal varices (GOV) and high-risk varices (HRV) detection in patients with compensated cirrhosis. The authors, including senior physicians in infectious diseases and ultrasound, reviewed the medical records and the following data were recorded on a case report form: participants' demographic, etiologic, and laboratory data; SD, ST, portal vein diameter (PVD) and spleen vein diameter (SVD) values; liver stiffness measurement (LSM), spleen stiffness measurement (SSM) by transient elastography (TE); and EGD results.
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