What Is Cirrhosis?

Cirrhosis is an advanced stage of fibrosis in which collagen deposits have interconnected, stiffening the liver structure and restricting blood flow through the liver. Cirrhosis and its complications cause over 30,000 deaths each year in the United States. The Conatus emricasan program has the potential to improve cirrhosis patients' lives in two major ways:

  1. It may help patients survive longer while waiting for a liver transplant.
  2. It may improve their liver disease status so they no longer need a transplant.

Conatus is studying treatment for patients with chronic liver disease including:

  • Compensated (asymptomatic) liver cirrhosis
  • Decompensated (symptomatic) liver cirrhosis

Causes of chronic decompensation or liver failure include:

  • Infections such as subacute bacterial peritonitis
  • Hepatitis C virus (HCV)
  • Hepatitis B virus (HBV)
  • Metabolic causes, such as nonalcoholic steatohepatitis (NASH)
  • Autoimmune diseases
  • Alcohol

Independent published studies have been conducted on cirrhosis treatment. They have shown that levels of caspase-cleaved Cytokeratin 18 (cCK18), a key biomarker of inflammation and apoptosis, are elevated in liver cirrhosis patients. These levels correlate with extent of liver inflammation and cholestasis.

Managing Cirrhosis

There are no approved disease-modifying treatments for cirrhosis. There are currently two main objectives for the management of patients with liver cirrhosis:

  1. Specific treatment of any identifiable causes of chronic liver function, such as HCV or HBV
  2. Prevention of the development or progression of key signs of decompensation

Signs of decompensation may include:

  • Portal hypertension
  • Ascites
  • Hepatic encephalopathy
  • Esophageal varices, with or without hemorrhage

The continual progression of liver cirrhosis may eventually lead patients to require a liver transplant. During this procedure, the diseased liver is replaced by a donor liver or part of one. There are not enough donor livers available for all cirrhosis patients. Without a liver transplant, progressive cirrhosis eventually leads to liver failure and death.

Conatus Cirrhosis Trials

Conatus is studying emricasan in cirrhosis patients in completed and planned clinical trials as described on our Programs page.