Future Pharmacological Therapies of Portal Hypertension

AbstractPurpose of ReviewTo provide an overview of recent pharmacological treatments for portal hypertension evaluated in early clinical trials, with particular emphasis on the pathophysiological basis of their use.Recent FindingsIn patients with compensated cirrhosis, even small decreases in portal pressure (as small as 1  mmHg) are associated with a lower probability of decompensation. In patients with decompensated cirrhosis, portal pressure “response” to non-selective beta-blocker (NSBB) therapy is associated with a lower mortality. When present, significant portal hypertension persists even after the elimina tion of the etiology of cirrhosis and this justifies the continued development of new drugs that target portal hypertension.SummaryOver several decades, we have gained great depth in the understanding of portal hypertension, its mechanisms and complications. NSBBs, which act by reducing portal venous inflow (an extrahepatic target), are effective in reducing portal pressure and have been the mainstay of therapy for portal hypertension in the last 35  years—being effective in preventing decompensation and variceal hemorrhage. However, because not all patients will have a sufficient response to NSBB and some may be intolerant to NSBB, alternative drugs or drugs that will augment the effect of NSBB on portal pressure are being tested in pre-cli nical and early-clinical trials. Many of these drugs target more than one of the intrahepatic or extrahepatic mechanism...
Source: Current Hepatitis Reports - Category: Infectious Diseases Source Type: research