LIVERHOPE: Simvastatin and rifaximin as new therapy for patients with decompensated cirrhosis

The objective of the LIVERHOPE project is to evaluate a novel therapeutic strategy for patients with cirrhosis based on a combination of rifaximin and simvastatin, targeting the main pathophysiological mechanisms of disease progression, namely the impairment in the gut–liver axis and the persistent hepatic and systemic inflammatory response. This dual therapeutic approach is supported by pre-clinical data. Two randomized double-blind trials are being conducted to investigate safety, tolerability, and efficacy of combination of simvastatin plus rifaximin in patients with decompensated cirrhosis in five European countries. The expected impact is to stop progression to acute-on-chronic liver failure (ACLF), the main cause of death, to decrease complications of the disease, to reduce hospital readmissions, to improve cost-effectiveness of therapy.