Author information

1. Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA.
2. Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
3. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
4. Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore.
5. NAFLD Research Center, Division of Gastroenterology and Hepatology. University of California at San Diego, La Jolla, California, USA.

Abstract

Background: Cirrhosis is increasingly common and morbid. Optimal utilisation of therapeutic strategies to prevent and control the complications of cirrhosis are central to improving clinical and patient-reported outcomes.

Methods: We conducted a narrative review of the literature focusing on the most recent advances.

Results: We review the aetiology-focused therapies that can prevent cirrhosis and its complications. These include anti-viral therapies, psychopharmacological therapy for alcohol-use disorder, and the current landscape of clinical trials for non-alcoholic steatohepatitis. We review the current standard of care and latest developments in the management of hepatic encephalopathy (HE), ascites and hepatorenal syndrome. We evaluate the promise and drawbacks of chemopreventative therapies that have been examined in trials and observational studies which may reduce the risk of hepatocellular carcinoma and cirrhosis complications. Finally, we examine the therapies which address the non-pain symptoms of cirrhosis including pruritis, muscle cramps, sexual dysfunction and fatigue.

Conclusion: The improvement of clinical and patient-reported outcomes for patients with cirrhosis is possible by applying evidence-based pharmacotherapeutic approaches to the prevention and treatment of cirrhosis complications.