My research has concentrated on finding out the reason why patients in advanced stages of cirrhosis develop complications. It is a stage of the disease called decompensated cirrhosis, when patients are at risk for developing trouble in other organ systems, and then their condition suddenly deteriorates. This scenario is known as acute-on-chronic liver failure, where there is a risk for kidney, brain and lung failure. So far, we know that bacterial infections are a major cause of acute-on-chronic liver failure, but there are other situations when there is inflammation without infection can also cause multi-organ failure. I have spent some time investigating kidney failure associated with liver failure. This is related to both a change in the circulation in these patients as well as the presence of inflammation. I have been studying the role of a group of compounds called vasoconstrictors to manipulate the circulation. These have helped to improve kidney function in these patients, suggesting that abnormalities in the circulation can cause kidney failure to occur in patients with cirrhosis. I have also been involved in studies to find out how changes of the bacteria in patients' guts can cause complications of cirrhosis. We are in the process of designing further studies to manipulate gut bacteria to reduce the risk for these patients to develop complications.
A study of a new drug for fatty liver disease
Study Status: active
Institute: Toronto General Hospital Research Institute
Study Purpose: The NATIV3 study is taking place in countries around the world to find out whether a medication called lanifibranor can help remove excess fat from the liver in adults with fatty liver disease and moderate liver damage. Researchers are studying how effective and safe the medication is.
Background: Fatty liver disease happens when too much fat builds up in the liver. Over time, this extra fat can cause inflammation and damage liver cells. As the liver tries to repair itself, scar tissue forms. If the damage continues for many years, more scar tissue can build up and lead to cirrhosis, a serious form of liver disease that increases the risk of liver cancer. Lanifibranor is a medication that works by helping the body process fat and sugar more effectively. It acts on specific targets in the liver and fat tissue, which can help break down fat, lower certain blood fats called triglycerides, improve the body's response to insulin, and keep blood sugar levels steady. It may also help reduce inflammation in the liver. By improving how the body handles fat and sugar and by reducing inflammation, lanifibranor may help decrease liver scarring and slow the progression of liver disease.
Study Methods: The first phase of the study compares the active drug to a placebo and lasts 72 weeks. After that, all patients will receive the active drug for an extended period to assess the longer-term safety of lanifibranor. A total of 1000 patients worldwide have been included in the trial. It is anticipated that the results will be available in late 2027.
Health Conditions:
Liver Diseases
- Professor, Division of Gastroenterology, Faculty of Medicine, University of Toronto