Project acronym: LIVERHOPE

Project full title: "Simvastatin and Rifaximin as new therapy for patients with decompensated cirrhosis"

Project description

Disease burden

Liver cirrhosis, similarly to congestive heart failure, chronic obstructive pulmonary disease or chronic kidney disease, represents the end-stage of a chronic disorder which results in severe and permanent damage of a vital organ.

In recent years, liver cirrhosis has emerged as a major cause of global health burden. In fact, in global burden of disease studies, performed in 2010 and 2013, liver cirrhosis was one of the leading causes of death in adults worldwide, both in males and females. In subjects within the 45-65 age range, cirrhosis was the 10th cause of death in males and the 15th cause of death in females (Fig. 1).

figure 1

Figure 1. Main causes of death in the world in 1990 (left panel) and 2013 (right panel). Lines connect the same disease in the two time periods (from The Lancet 2015; 385:117-71).


The number of deaths due to cirrhosis in Europe has been estimated to be around 170,000 annually, with varying mortality rates in different European countries (Fig 2).

figure 2

Figure 2. Age-standardized death rates per 100,000 population from liver cirrhosis in European countries, males and females aged 20–64; WHO mortality database 2000–2002 (from Blachier, J Hepatol 2013).

Moreover, liver cirrhosis is one of the leading diseases in disability-adjusted life years (DALYs) and has a major effect in patients’ quality of life. This indicates that cirrhosis is one of the chronic diseases with greatest impact in patients’ life.

In addition to high mortality and impaired quality-of-life, cirrhosis is responsible for a high number of hospitalizations which represent a high burden for health systems.

Unfortunately, treatment of complications of cirrhosis has not changed substantially within the last 20 years and the majority of drugs used in the management of patients with cirrhosis were introduced during the 1980’s and 1990’s.

References
Naghavi M, The Lancet 2015
Solà, J Hepatol 2012
Graupera and Ginès, Hepatology 2015