Emerging synthetic drugs for the treatment of hepatic cirrhosis: a 2024 update

Cirrhosis is associated with a substantial, and increasing, health and socioeconomic burden worldwide. The leading causes of cirrhosis are steatotic liver diseases (including alcohol-related liver disease and metabolic dysfunction-associated steatohepatitis (MASH, formerly nonalcoholic steatohepatitis (NASH)) and chronic viral hepatitis. Owing to rising rates of alcohol consumption, an aging general population, and a spiralling prevalence of metabolic risk factors, a dramatic escalation in cirrhosis-related morbidity and mortality is predicted [1]. It currently ranks tenth among the leading causes of death in Africa (compared to thirteenth in 2015), ninth in Southeast Asia and Europe, and fifth in the Eastern Mediterranean [1]. Cirrhosis is associated with huge healthcare costs, with the bulk of this expenditure attributable to inpatient or emergency department care. Furthermore, cirrhosis causes wide-ranging socioeconomic effects including reduced employment and loss of productivity, and impaired health-related quality of life (HRQoL).
In this editorial, we provide an update on our 2021 review of emerging synthetic drugs for cirrhosis [2], consider the setbacks and progress over the past three years, and provide some future insights.