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Learn About Liver Conditions and Diseases

Fatty Liver Disease (NAFLD, NASH)

healthy liver compared to fattly liverNon-alcoholic fatty liver disease (NAFLD) is a chronic liver disease in which too much fat is stored in the liver.  Normally, there are no symptoms, and the condition is discovered during blood tests or other diagnostic tests.  As the name implies, it is not caused by alcoholism or alcohol abuse.  The most common risk factors of NAFLD are obesity, gastric bypass surgery, high cholesterol, and type 2 diabetes. If the disease progresses, it can lead to non-alcoholic steatosis (NASH).

NASH is a severe form of NAFLD. It is the most common form of liver disease in the United States.  Like NAFLD, there are usually no symptoms. In NASH, the liver is inflamed and after years of inflammation, the liver can develop scar tissue or “fibrosis”.  Severe fibrosis is called cirrhosis.

The liver research team, part of Tulane's Section of Gastoenterology and Hepatology, contributes to the research of fatty liver disease (NASH and NAFLD).  We are currently enrolling volunteers for the following studies:

  • Galectin 031:  A seamless, adaptive, Phase 2b/3. double-blind, randomized, placebo-controlled, multi-center, international study evaluating the efficacy and safety of Belapectin (GR-MD-02) for the prevention of esophageal varices in NASH cirrhosis (PI: Dr. Fredric Regenstein)
  • Lakeside Life Sciences LLS-019: Evaluation of the diagnostic performance of the M30 Apoptosense® M65 and M65 EpiDeath ELISA Assay results to stratify non-alcoholic steatohepatitis (NASH) from simple steatosis in a cohort of patients suspected of nonalcoholic Fatty Liver Disease (NAFLD) (PI: Dr. Martin Moehlen)
  • Viking VK2809-202:  A Phase 2B, randomized double-blind, placebo-controlled, multi-center study to assess the efficacy, safety and tolerability of VK 2809 administered for 52 weeks, followed by a 4-week off-drug phase in subjects with biopsy proven, non-alcoholic steatohepatitis with fibrosis. (PI: Dr. Martin Moehlen) NCT04173065
  • Madrigal MGL-3196-11: A Phase 3, multinational, double-blind, randomized, placebo-controlled study of MGL-3196 (resmetirom) in patients with non-alcoholic steatohepatitis (NASH) and fibrosis to resolve NASH and reduce progression to cirrhosis and/or hepatic decompensation (PI: Dr. Martin Moehlen)  NCT03900429

If you would like more information about liver disease, call 504-988-5344.

If you are interested in participating in research, please contact us at 504-988-3047 or click here to request additional information.

Hepatocellular Carcinoma (HCC or Liver Cancer)

Liver cancer graphic - healthy liver compared to liver cancer

Hepatocellular carcinoma (HCC) is a primary cancer of the liver. HCC is rare in the general population but is unfortunately common in patients with severe scarring of the liver (cirrhosis) from any cause. HCC is also common in patients with longstanding chronic hepatitis B without cirrhosis. Liver tumors can often be diagnosed confidently with non-invasive radiology scans (ultrasound, CAT scans, or MRI) and no biopsy. HCC is a particularly deadly cancer if not treated aggressively. Small cancers can be treated with minimally invasive techniques or a liver transplant. Larger tumors or cancers that have spread outside the liver (metastatic) are generally not curable. Incurable tumors can be palliated with very targeted, minimally invasive therapy or oral chemotherapy.

The liver research team, part of Tulane's Section of Gastoenterology and Hepatology, contributes to the research of liver cancer (HCC).  We are currently enrolling volunteers for the following studies.

  • Merck MK7902 HCC: A Phase 3 multicenter, randomized, double-blinded, active-controlled clinical study to evaluate the safety and efficacy of Lenvatinib with Pembrolizumab in combination with transarterial chemoembolization (TACE) versus TACE in participants with incurable/non-metastatic hepatocellular carcinoma. (PI: Dr. Martin Moehlen)

  •  Bristol Myers Squibb CA2099DX: A Phase 3, randomized, double-blind study of adjuvant Nivolumab versus placebo for participants with HCC who are at high risk of recurrence after curative hepatic resection or ablation (PI: Dr. Martin Moehlen)

For more information about diagnosis or treatment options please call 504-988-5344.

If you are interested in participating in research, please contact us at 504-988-3047 or click here to request additional information.

Cirrhosis

liver diseases stages: healthy, fatty, fibrosis, cirrhosis

Cirrhosis is a liver condition in which scar tissue has replaced liver tissue after years of damage. Diseases that may lead to cirrhosis include fatty liver disease, hepatitis B, bile duct diseases (primary biliary cholangitis and primary sclerosing cholangitis), genetic disorders, and autoimmune hepatitis. But the most common causes of cirrhosis are hepatitis C and alcohol-related disease.  In the early stages, there are few if any symptoms, but as the disease progresses, symptoms may include abdominal pain, loss of appetite, weight loss, itching and fatigue.  In later stages, there may be jaundice (yellowing of the eyes and skin), bruising, and swelling of the abdomen and legs.

Treatment of cirrhosis begins with treating the underlying cause of liver damage in order to prevent further damage. For instance, if the cause of cirrhosis is fatty liver disease, weight loss and diet may prevent further damage.  If the cirrhosis is the result of hepatitis B or C, the virus can be treated with medication.

In later stages of cirrhosis, liver transplant may be an option. 

New medications are being developed to manage cirrhosis, and the liver research team, part of Tulane's Section of Gastoenterology and Hepatology, contributes to the research of liver cirrhosis.  We are currently enrolling volunteers for the following studies:

  •  Helio LAM-2018-01: A prospective clinical trial to detect liver cancer through quantification of cfDNA Methylation in blood samples (CLiMB) (PI: Dr. Martin Moehlen)  NCT03694600
  • Galectin GT-031 A seamless, adaptive, Phase 2b/3. double-blind, randomized, placebo-controlled, multi-center, international study evaluating the efficacy and safety of Belapectin (GR-MD-02) for the prevention of esophageal varices in NASH cirrhosis (PI: Dr. Fredric Regenstein) NCT04365868
  • Gilead GS-US-454-6075: A Phase 2, randomized, double-blind, double-dummy, placebo-controlled study evaluating the safety and efficacy of Semaglutide, and the fixed-dose combination of Cilofexor and Firsocostat, alone and in combination, in subjects with compensated cirrhosis (F4) due to nonalcoholic steatohepatitis (NASH) (PI: Dr. Moehlen) NCT04971785

If you would like more information about liver disease, call 504-988-5344.  If you are interested in participating in research, please contact us at 504-988-3047 or click here to request additional information.

PBC (Primary Biliary Cholangitis)

Primary biliary cholangitis (PBC) is a chronic disease that affects the liver.  In PBC, the bile ducts of the liver become damaged, causing bile to back up in the liver which can lead to scarring (cirrhosis).  The cause of PBC is unknown, but it is most likely an autoimmune disease and probably genetic.  Often, there are no symptoms, but common early symptoms include fatigue, itchiness (pruritus), and in severe cases, jaundice.

Currently, there is no cure for PBC, but medication can manage the disease and slow the progression of liver damage.  There is also promising research for medication to treat and manage PBC.

The liver research team, part of Tulane's Section of Gastoenterology and Hepatology, contributes to the research of PBC.  We are currently enrolling volunteers for the following studies:

  •  CymaBay CB8025-31731: A long-term, open label study to evaluate the safety and tolerability of Seladelpar in subjects with PBC. (PI: Dr. Martin Moehlen)
  •  CymaBay CB8025-32048: A placebo-controlled, randomized, phase 3 study to evaluate the efficacy and safety of Seladelpar in patients with primary biliary cholangitis (PBC) and an inadequate control to or an intolerance to ursodeoxycholic acid (UDCA) (PI: Dr. Martin Moehlen)

For more information about diagnosis or treatment options please call 504-988-5344.

If you are interested in participating in research, please contact us at 504-988-3047 or click here to request additional information.

Hepatitis B (HBV)

hepatitis B virus illustrationHepatitis B is a viral infection of the liver. In acute infection patients may experience nausea, vomiting, jaundice (yellowing of the skin), and abdominal pain. Infection in adults is usually acquired through sexual contact or needle sticks. Most adults will clear the acute infection and be protected from hepatitis B infection thereafter. A small percentage of patients will remain chronically infected with the virus remaining in their blood and liver indefinitely. Chronic infection can lead to severe liver scarring and liver failure (cirrhosis). It also puts the patient at higher risk of liver cancer (hepatocellular carcinoma). Young children may become chronically infected during the birth process or through household exposure. Infected children do not often acquire the acute symptoms listed above; however, their lifetime risk of cirrhosis and cancer is high if not treated. Treatment of chronic hepatitis B can suppress the virus and decrease the risk of chronic liver damage. We specialize in the individualized treatment of chronic HBV and offer clinical trials that are advancing the field. Patients are often followed with occasional blood tests. A liver biopsy is occasionally recommended to guide treatment.

For more information please call 504-988-5344

Hepatitis C (HCV)

Chronic hepatitis C is a viral infection (HCV) which can lead to serious liver disorders such as cirrhosis and liver cancer. Today HCV is one of the leading causes of liver failure requiring transplantation in the United States. Despite what is commonly written in the media, HCV is curable in many patients. Currently treatments involve antiviral medications (DAA's) for 8 to 12 weeks. The Section of Gastroenterology and Hepatology was involved in the cutting edge research leading to the FDA approval of currently used HCV therapies. The late world renowned hepatologist and gastroenterologist, Luis Balart, MD, MACG describes in the video below the HCV research that was taking place within the Section.

For more information please call 504-988-5344