Due to various risk factors the prevalence of hepatic encephalopathy has been increasing globally. The risk factors for the disease include the consumption of alcohol, drugs addiction for sedatives such as benzodiazepines; often used in treatment of anxiety disorders that can suppress the alcohol withdrawal, challenges in the correct diagnosis and other infections, such as jaundice and deficiency of liver enzymes. According to the Journal of Gastrointestinal & Digestive System, studies proves that in developed countries hepatic Encephalopathy affects the quality of life in around 70% of the patients suffering from liver cirrhosis. Hepatic encephalopathy is majorly diagnosed in the patients with liver cirrhosis. The therapeutic pipeline of hepatic Encephalopathy is expected to grow in the near future due to the involvement of several multinational pharmaceutical companies who have focused their research and development program on the production of a novel drugs for the treatment of hepatic encephalopathy.
Hepatic encephalopathy is a condition in which dysfunction of brain is observed in people with acute liver failure. The brain is the most important and sensitive organ in the body that relies on liver to perform various important biological functions. This condition can also occur due to kidney problems. According to the pathogenesis of hepatic encephalopathy, the liver has a detoxifying role in the body and has the capability of neutralizing numerous toxic chemicals which are absorbed from gastrointestinal tract. Most of the toxins going to the liver are pass through the portal venous system and these substances are effectively captured and detoxified by hepatocytes. With the progression of liver fibrosis and development of cirrhosis, the increased hepatic resistance forces the blood to bypass the liver by flowing through portosystemic shunts. This result in the pooling of various toxins into the systemic circulation which finally reaches the brain and other organs. The symptoms of the disease primarily associated with hepatic encephalopathy include Mood swings, reduced alertness, confusion, depression, disturbance in sleep pattern and anxiousness.
There are different types of therapeutic drugs present under the pipeline of various pharmaceutical companies for the treatment of hepatic Encephalopathy. RBX2477 is a drug developed by the Rebiotix Inc. It is presently under the Phase I clinical trial and is administered orally. RBX2477 is an antibiotic that reduces the ammonia production by inhibiting the growth of ammonia-producing colonic bacteria. OCR-002 (Ornithine phenylacetate) is a drug developed by Ocera Therapeutics Inc. It is presently under the phase I clinical trial and is administered orally. OCR-002 is a small molecule that acts as an ammonia scavenger and lowers down the abnormally increasing ammonia. KLS-13019 is a drug developed by Kanna Life Sciences and is currently under the pre-clinical phase. It is a cannabinoid which acts on cannabinoid receptors in cells which alters the neurotransmitter release inside the brain. All these drugs (RBX2477, OCR-002 & KLS-13019) have shown efficacy for the treatment of hepatic encephalopathy.
Some of the companies having a pipeline of hepatic encephalopathy include Kanna Life Sciences Inc., Horizon Pharma Plc, Rebiotix Inc, Ocera Therapeutics Inc., Umecrine Cognition AB, Spherium Biomed S.L., and COSMO Pharmaceuticals S.A