Review
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2019; 25(8): 888-908
Published online Feb 28, 2019. doi: 10.3748/wjg.v25.i8.888
Current and future pharmacological therapies for managing cirrhosis and its complications
David Kockerling, Rooshi Nathwani, Roberta Forlano, Pinelopi Manousou, Benjamin H Mullish, Ameet Dhar
David Kockerling, Rooshi Nathwani, Roberta Forlano, Pinelopi Manousou, Benjamin H Mullish, Ameet Dhar, Liver Unit/Division of Integrative Systems Medicine and Digestive Disease, Imperial College London, London W2 1NY, United Kingdom
Author contributions: Kockerling D and Nathwani R performed the literature search and wrote the first draft of the manuscript; Mullish BH, Manousou P, Forlano R and Dhar A provided critical review of the first draft and contributed to amendment of the text; all authors contributed to and approved the final submission.
Supported by The Division of Integrative Systems Medicine and Digestive Disease at Imperial College London receives financial support from the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre (BRC) based at Imperial College Healthcare NHS Trust and Imperial College London. This article is independently funded by the NIHR BRC, and the views expressed in this publication are those of the authors and not necessarily those of the NHS, NIHR, or the Department of Health. Mullish BH is the recipient of a Medical Research Council Clinical Research Training Fellowship (grant number: MR/R00875/1). Forlano R is the recipient of the EASL Juan Rodes PhD fellowship.
Conflict-of-interest statement: None declared for all authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ameet Dhar, BSc, MBBS, MRCP, PhD, Consultant Hepatologist, Liver Unit/Division of Integrative Systems Medicine and Digestive Disease, Imperial College London, 10th Floor, QEQM Wing, St Mary’s Hospital Campus, South Wharf Road, Paddington, London W2 1NY, United Kingdom. a.dhar@imperial.ac.uk
Telephone: +44-20-33126454 Fax: +44-20-77249369
Received: December 7, 2018
Peer-review started: December 9, 2018
First decision: January 11, 2019
Revised: January 17, 2019
Accepted: January 26, 2019
Article in press: January 26, 2019
Published online: February 28, 2019
Processing time: 82 Days and 15.9 Hours
Core Tip

Core tip: Pharmacological therapy is central to the management of cirrhosis and its complications. Whilst there has been recent debate about the safety of beta-blockade in patients with ascites, conversely there is growing interest in potential benefits relating to a reduction in gut bacterial translocation and hepatocellular carcinoma risk. In addition to its well-established role in treating hepatic encephalopathy, rifaximin may also have a key role in preventing secondary infections. In this review, we summarise these and other uncertainties, controversies and novel developments related to pharmacotherapy in the clinical management of chronic liver disease.