Introduction: Advanced chronic liver disease is considered a reversible condition after removal of the primary etiological factor. This has led to a paradigm shift in which portal hypertension (PH) is a reversible complication of cirrhosis. The pharmacologic management of PH is centered on finding targets to modify the natural history of cirrhosis and PH.
Areas covered: This paper offers an overview of the use of pharmacological strategies in early clinical development that modify PH. Papers included were selected from searching clinical trial sites and PubMed from the last 10 years.
Expert opinion: A paradigm shift has generated a new concept of PH in cirrhosis as a reversible complication of a potentially curable disease. Decreasing portal pressure to prevent decompensation and further complications of cirrhosis that may lead liver transplantation or death is a goal. Therapeutic strategies also aspire achieve total or partial regression of fibrosis, thus eliminating the need for treatment or screening of PH.
Keywords: Cirrhosis; chronic liver disease; hepatic; hepatic venous pressure gradient; portal pressure.