DECOMPENSATED CIRRHOSIS: IDENTIFICATION OF NEW COMBINATORIAL THERAPIES BASED ON SYSTEMS APPROACHES | DECISION Project | Fact Sheet | H2020 | CORDIS | European Commission (2024)

DECOMPENSATED CIRRHOSIS: IDENTIFICATION OF NEW COMBINATORIAL THERAPIES BASED ON SYSTEMS APPROACHES | DECISION Project | Fact Sheet | H2020 | CORDIS | European Commission (1)

Project description

DEENESFRITPL

Combinatorial therapy for decompensated cirrhosis

Cirrhosis mortality is mainly associated with cirrhosis decompensation (development of ascites, hepatic encephalopathy, gastrointestinal haemorrhage, and progression to acute-on-chronic liver failure (ACLF). Despite multiple treatments, mortality in patients with decompensation of cirrhosis remains high. The EU-funded DECISION project aims to understand the pathophysiology of decompensation of cirrhosis leading to ACLF or death, and to decrease patient mortality. The project will study the pathophysiology of decompensation of cirrhosis by integrating results of high-throughput multi-omic profiling with comprehensive clinical data from 2 200 fully characterised patients with available standardised biological samples. DECISION will help to identify novel combinatorial therapies to prevent high mortality for patients with decompensation of cirrhosis. Finally, researchers will optimise these therapies in new animal models and then test the best combination in high-risk patients in a Phase II clinical trial.

Objective

In 2013, cirrhosis was responsible for 1.2 million deaths worldwide. This mortality is mainly due to cirrhosis decompensation, i.e. development of ascites, hepatic encephalopathy, and/or gastrointestinal hemorrhage, and its progression to acute-on-chronic liver failure (ACLF). Patients with decompensated cirrhosis receive many treatments such as intravenous and oral absorbable antibiotics, oral non-absorbable antibiotics, albumin, proton-pump inhibitors, laxatives, diuretics, betablockers, vasoconstrictors, statins, anticoagulants, steroids and antiviral agents. Despite these multiple treatments, ACLF or mortality in patients with decompensation of cirrhosis remains high (15% at day 28, 28% at day 90) because of large interindividual variability in precipitating events, in clinical presentation and in response to treatment. This heterogeneity calls for treatment personalization according to underlying mechanisms. The objective of DECISION is to enhance our understanding, at systems level, of the pathophysiology of decompensation of cirrhosis leading to ACLF or death to decrease patients’ mortality at day 28.
First, DECISION will improve our knowledge of the pathophysiology of decompensation of cirrhosis by integrating results of high-throughput multi-omic profiling with comprehensive clinical data from 2,200 fully characterized patients (more than 8,600 time points) with available standardized biological samples. Second, we will identify novel combinatorial therapies for patients with decompensation of cirrhosis to prevent death. We will refine these therapies in new and/or optimized animal models and then test the best combination in high risk patients in a phase II clinical trial built in DECISION. Third, we will develop 2 tests: one predicting outcome of patients with decompensation of cirrhosis when treated with standard treatment (prognostic test); and the other identifying patients who will respond to the novel combinatorial therapy (test for response).

Fields of science

  • social sciencessociologydemographymortality
  • medical and health sciencesbasic medicinephysiologypathophysiology
  • medical and health sciencesbasic medicinepharmacology and pharmacypharmaceutical drugsantibiotics
  • medical and health sciencesclinical medicinehepatology

Keywords

  • cirrhosis
  • decompensation of cirrhosis
  • survival
  • combinatorial therapy
  • infection
  • omics

Programme(s)

  • H2020-EU.3.1. - SOCIETAL CHALLENGES - Health, demographic change and well-being Main Programme
  • H2020-EU.3.1.1. - Understanding health, wellbeing and disease

Topic(s)

  • SC1-BHC-02-2019 - Systems approaches for the discovery of combinatorial therapies for complex disorders

Call for proposal

H2020-SC1-BHC-2018-2020

See other projects for this call

Sub call

H2020-SC1-2019-Two-Stage-RTD

Funding Scheme

RIA - Research and Innovation action

Coordinator

EUROPEAN FOUNDATION FOR THE STUDY OF CHRONIC LIVER FAILURE (EF-CLIF)

Net EU contribution

€ 1 233 650,00

Address

TRAVESSERA DE GRACIA 11, 7TH FLOOR
08021 Barcelona
Spain

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Region

Este Cataluña Barcelona

Activity type

Research Organisations

Links

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Total cost

€ 1 233 650,00

Participants (25)

FUNDACIO DE RECERCA CLINIC BARCELONA-INSTITUT D INVESTIGACIONS BIOMEDIQUES AUGUST PI I SUNYER

Spain

Net EU contribution

€ 326 818,00

Address

CARRER ROSSELLO 149
08036 Barcelona

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Region

Este Cataluña Barcelona

Activity type

Research Organisations

Links

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Total cost

€ 371 723,13

Third-party

Legal entity other than a subcontractor which is affiliated or legally linked to a participant. The entity carries out work under the conditions laid down in the Grant Agreement, supplies goods or provides services for the action, but did not sign the Grant Agreement. A third party abides by the rules applicable to its related participant under the Grant Agreement with regard to eligibility of costs and control of expenditure.

HOSPITAL CLINIC DE BARCELONA

Spain

Net EU contribution

€ 44 904,00

Address

CALLE VILLARROEL 170
08036 Barcelona

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Region

Este Cataluña Barcelona

Activity type

Research Organisations

Links

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Total cost

€ 44 905,00

ERASMUS UNIVERSITAIR MEDISCH CENTRUM ROTTERDAM

Netherlands

Net EU contribution

€ 300 000,00

Address

DR MOLEWATERPLEIN 40
3015 GD Rotterdam

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Region

West-Nederland Zuid-Holland Groot-Rijnmond

Activity type

Higher or Secondary Education Establishments

Links

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Total cost

€ 300 000,00

INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE MEDICALE

France

Net EU contribution

€ 578 738,75

Address

RUE DE TOLBIAC 101
75654 Paris

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Region

Ile-de-France Ile-de-France Paris

Activity type

Research Organisations

Links

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Total cost

€ 620 500,00

Third-party

Legal entity other than a subcontractor which is affiliated or legally linked to a participant. The entity carries out work under the conditions laid down in the Grant Agreement, supplies goods or provides services for the action, but did not sign the Grant Agreement. A third party abides by the rules applicable to its related participant under the Grant Agreement with regard to eligibility of costs and control of expenditure.

UNIVERSITE PARIS CITE

France

Net EU contribution

€ 41 761,25

Address

85 BD SAINT GERMAIN
75006 Paris

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Region

Ile-de-France Ile-de-France Paris

Activity type

Higher or Secondary Education Establishments

Links

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JOHANN WOLFGANG GOETHE-UNIVERSITAET FRANKFURT AM MAIN

Participation ended

Germany

Net EU contribution

€ 257 692,00

Address

THEODOR W ADORNO PLATZ 1
60323 Frankfurt Am Main

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Region

Hessen Darmstadt Frankfurt am Main, Kreisfreie Stadt

Activity type

Higher or Secondary Education Establishments

Links

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Total cost

€ 257 692,93

UNIVERSITAETSKLINIKUM AACHEN

Germany

Net EU contribution

€ 275 874,00

Address

Pauwelsstrasse 30
52074 Aachen

See on map

Region

Nordrhein-Westfalen Köln Städteregion Aachen

Activity type

Higher or Secondary Education Establishments

Links

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Total cost

€ 275 874,38

COMMISSARIAT A L ENERGIE ATOMIQUE ET AUX ENERGIES ALTERNATIVES

France

Net EU contribution

€ 345 000,00

Address

RUE LEBLANC 25
75015 PARIS 15

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Region

Ile-de-France Ile-de-France Paris

Activity type

Research Organisations

Links

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Total cost

€ 345 000,00

FUNDACION PUBLICA MIGUEL SERVET

Spain

Net EU contribution

€ 382 500,00

Address

CALLE IRUNLARREA 3 CENTRO INVESTIGACION BIOMEDICA RECINTO COMPLEJO HOSPITALARIO DE NAVARRA
31008 Pamplona

See on map

Region

Noreste Comunidad Foral de Navarra Navarra

Activity type

Research Organisations

Links

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Total cost

€ 382 500,00

YH YOUHEALTH AB

Sweden

Net EU contribution

€ 260 000,00

Address

FOGDEVRETEN 2 KAROLINSKA SCIENCE
171 77 Stockholm

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SME

The organization defined itself as SME (small and medium-sized enterprise) at the time the Grant Agreement was signed.

Yes

Region

Östra Sverige Stockholm Stockholms län

Activity type

Private for-profit entities (excluding Higher or Secondary Education Establishments)

Links

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Total cost

€ 260 000,00

NORDIC BIOSCIENCE A/S

Denmark

Net EU contribution

€ 66 043,00

Address

HERLEV HOVEDGADE 205-207
2730 Herlev

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SME

The organization defined itself as SME (small and medium-sized enterprise) at the time the Grant Agreement was signed.

Yes

Region

Danmark Hovedstaden Københavns omegn

Activity type

Private for-profit entities (excluding Higher or Secondary Education Establishments)

Links

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Total cost

€ 66 043,00

ALMA MATER STUDIORUM - UNIVERSITA DI BOLOGNA

Italy

Net EU contribution

€ 161 898,00

Address

VIA ZAMBONI 33
40126 Bologna

See on map

Region

Nord-Est Emilia-Romagna Bologna

Activity type

Higher or Secondary Education Establishments

Links

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Total cost

€ 171 723,75

Third-party

Legal entity other than a subcontractor which is affiliated or legally linked to a participant. The entity carries out work under the conditions laid down in the Grant Agreement, supplies goods or provides services for the action, but did not sign the Grant Agreement. A third party abides by the rules applicable to its related participant under the Grant Agreement with regard to eligibility of costs and control of expenditure.

IRCCS AZIENDA OSPEDALIERO- UNIVERSITARIA DI BOLOGNA

Italy

Net EU contribution

€ 9 824,00

Address

VIA ALBERTONI 15
40138 Bologna

See on map

Region

Nord-Est Emilia-Romagna Bologna

Activity type

Public bodies (excluding Research Organisations and Secondary or Higher Education Establishments)

Links

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Total cost

€ 9 825,00

SERVICIO MADRILENO DE SALUD

Spain

Net EU contribution

€ 105 472,00

Address

Paseo De la Castellana, 280
28046 MADRID

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Region

Comunidad de Madrid Comunidad de Madrid Madrid

Activity type

Public bodies (excluding Research Organisations and Secondary or Higher Education Establishments)

Links

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Total cost

€ 105 472,50

UNIVERSITY COLLEGE LONDON

United Kingdom

Net EU contribution

€ 105 879,00

Address

GOWER STREET
WC1E 6BT London

See on map

Region

London Inner London — West Camden and City of London

Activity type

Higher or Secondary Education Establishments

Links

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Total cost

€ 105 879,13

UNIVERSITA DEGLI STUDI DI PADOVA

Italy

Net EU contribution

€ 42 500,00

Address

VIA 8 FEBBRAIO 2
35122 Padova

See on map

Region

Nord-Est Veneto Padova

Activity type

Higher or Secondary Education Establishments

Links

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Total cost

€ 42 500,00

UNIVERSITA DEGLI STUDI DI TORINO

Italy

Net EU contribution

€ 75 472,00

Address

VIA GIUSEPPE VERDI 8
10124 Torino

See on map

Region

Nord-Ovest Piemonte Torino

Activity type

Higher or Secondary Education Establishments

Links

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Total cost

€ 105 472,50

Third-party

Legal entity other than a subcontractor which is affiliated or legally linked to a participant. The entity carries out work under the conditions laid down in the Grant Agreement, supplies goods or provides services for the action, but did not sign the Grant Agreement. A third party abides by the rules applicable to its related participant under the Grant Agreement with regard to eligibility of costs and control of expenditure.

AZIENDA OSPEDALIERA CITTA DELLA SALUTE E DELLA SCIENZA DI TORINO

Italy

Net EU contribution

€ 30 000,00

Address

CORSO BRAMANTE 88 90
10126 Torino

See on map

Region

Nord-Ovest Piemonte Torino

Activity type

Public bodies (excluding Research Organisations and Secondary or Higher Education Establishments)

Links

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Total cost

€ 30 000,00

INSTITUT CATALA DE LA SALUT

Spain

Net EU contribution

€ 105 472,00

Address

GRAN VIA DE LES CORTS CATALANES 587
08007 Barcelona

See on map

Region

Este Cataluña Barcelona

Activity type

Public bodies (excluding Research Organisations and Secondary or Higher Education Establishments)

Links

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Total cost

€ 105 472,50

UNIVERSITAT DE BARCELONA

Spain

Net EU contribution

€ 120 000,00

Address

GRAN VIA DE LES CORTS CATALANES 585
08007 Barcelona

See on map

Region

Este Cataluña Barcelona

Activity type

Higher or Secondary Education Establishments

Links

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Total cost

€ 120 000,00

ASSISTANCE PUBLIQUE HOPITAUX DE PARIS

France

Net EU contribution

€ 420 472,00

Address

55 BOULEVARD DIDEROT
75012 Paris

See on map

Region

Ile-de-France Ile-de-France Val-de-Marne

Activity type

Research Organisations

Links

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Total cost

€ 420 472,50

EUROPEAN ASSOCIATION FOR THE STUDYOF THE LIVER

Switzerland

Net EU contribution

€ 50 000,00

Address

RUE DAUBIN 7
1203 Geneve

See on map

Region

Schweiz/Suisse/Svizzera Région lémanique Genève

Activity type

Other

Links

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Total cost

€ 50 000,00

EUROPEAN LIVER PATIENTS ASSOCIATION

Belgium

Net EU contribution

€ 50 000,00

Address

PLACE DU CHAMPS DE MARS 5
1050 Bruxelles / Brussel

See on map

Region

Région de Bruxelles-Capitale/Brussels Hoofdstedelijk Gewest Région de Bruxelles-Capitale/ Brussels Hoofdstedelijk Gewest Arr. de Bruxelles-Capitale/Arr. Brussel-Hoofdstad

Activity type

Other

Links

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Total cost

€ 50 000,00

CONCENTRIS RESEARCH MANAGEMENT GMBH

Germany

Net EU contribution

€ 488 500,00

Address

Ludwigstr. 4
82256 FURSTENFELDBRUCK

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SME

The organization defined itself as SME (small and medium-sized enterprise) at the time the Grant Agreement was signed.

Yes

Region

Bayern Oberbayern Fürstenfeldbruck

Activity type

Private for-profit entities (excluding Higher or Secondary Education Establishments)

Links

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Total cost

€ 488 500,00

UNIVERSITAET MUENSTER

Germany

Net EU contribution

€ 121 530,00

Address

SCHLOSSPLATZ 2
48149 MUENSTER

See on map

Region

Nordrhein-Westfalen Münster Münster, Kreisfreie Stadt

Activity type

Higher or Secondary Education Establishments

Links

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Total cost

€ 121 530,81

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Last update: 1 April 2024

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Permalink: https://cordis.europa.eu/project/id/847949

European Union, 2024

DECOMPENSATED CIRRHOSIS: IDENTIFICATION OF NEW COMBINATORIAL THERAPIES BASED ON SYSTEMS APPROACHES | DECISION Project | Fact Sheet | H2020 | CORDIS | European Commission (2024)

FAQs

What are four signs of decompensated cirrhosis? ›

Decompensated cirrhosis is defined as an acute deterioration in liver function in a patient with cirrhosis and is characterised by jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome or variceal haemorrhage.

Can decompensated cirrhosis be reversed to compensated? ›

As we mentioned earlier, while it can be reversed, this is actually a rare occurrence. The best way to manage cirrhosis is to work closely with a gastrointestinal doctor to stop your liver damage before it progresses.

How long can I live with decompensated cirrhosis? ›

How long can a person live with cirrhosis of liver? The life expectancy of a person with liver cirrhosis will depend on the stage of cirrhosis and other factors, such as how they are managing the condition. Typically, the life expectancy for a person with cirrhosis of the liver is around 2–12 years.

Is decompensated cirrhosis a death sentence? ›

In the early stages of compensated cirrhosis, life expectancy may still be upwards of 15 years. When portal hypertension develops, it reduces that expectancy, primarily due to the risk of internal bleeding it can cause. Decompensated cirrhosis has an average life expectancy of seven years.

What are the signs your liver is shutting down? ›

Acute liver failure can develop quickly in an otherwise healthy person, and it is life-threatening. If you or someone you know suddenly develops a yellowing of the eyes or skin; tenderness in the upper abdomen; or any unusual changes in mental state, personality or behavior, seek medical attention right away.

What is the Meld score for decompensated cirrhosis? ›

The MELD score provides accurate short-term prognostic information and should be calculated on any person with cirrhosis. Individuals with a MELD score greater than or equal to 15 or decompensated cirrhosis, should be considered for a liver transplantation evaluation.

Can a decompensated liver regenerate? ›

Myth: I might have cirrhosis, but the liver will regenerate and heal itself naturally. Fact: The liver is a highly regenerative organ but only if it's still healthy enough to do so and doesn't have extensive scar tissue. Once cirrhosis is present, your liver's regeneration becomes very limited.

Does decompensated cirrhosis qualify for disability? ›

An individual may qualify for SSDI and/or SSI for any number of conditions, including chronic liver disease or cirrhosis. If your liver disease has progressed to the point where you can no longer work, then your application for disability benefits may be approved.

What causes death in decompensated cirrhosis? ›

Patients who have developed complications of cirrhosis, such as variceal hemorrhage, ascites, spontaneous bacterial peritonitis, hepatocellular carcinoma (HCC), hepatorenal syndrome, or hepatopulmonary syndrome, are considered to have decompensated cirrhosis. These complications are the primary causes of death in ESLD.

What are the signs of dying from cirrhosis of the liver? ›

Symptoms of decompensated cirrhosis might include:
  • Yellow discolouration of the skin (jaundice)
  • Fluid retention with abdominal distension (ascites)
  • Leg swelling (oedema)
  • Confusion (encephalopathy)
  • Bleeding from abnormal blood vessels (varices) in the oesophagus and stomach (internal bleeding)

What are the three worst things for your liver? ›

Foods that are high in sugar, fat, and salt put extra stress on the liver. Fast food, packaged foods, and processed foods tend to contain a lot of these elements.

What is end stage decompensated liver disease? ›

Chronic liver failure, also called end-stage liver disease, progresses over months, years, or decades. Most often, chronic liver failure is the result of cirrhosis, a condition in which scar tissue replaces healthy liver tissue until the liver cannot function adequately.

Can decompensated cirrhosis get better? ›

How is decompensated cirrhosis treated? There are limited treatment options for decompensated cirrhosis. At this later stage of liver disease, it's usually not possible to reverse the condition. But this also means that people with decompensated cirrhosis are often good candidates for a liver transplant.

Is decompensated liver cirrhosis terminal? ›

Decompensated cirrhosis has a high mortality rate. Research suggests that decompensated cirrhosis has a mortality rate of 85% within 5 years if people do not receive a liver transplant. To determine the outlook, healthcare professionals may use the model for end stage liver disease (MELD) score.

Is ascites a death sentence? ›

Still, for those patients who develop ascites from cirrhosis, half will die within three years. If refractory ascites occurs, the mortality rate at one year is 50%.

How do you know death is near with cirrhosis of the liver? ›

Someone with liver failure who is nearing death is described as having end-stage liver disease. This can cause symptoms such as jaundice, confusion and uncertainty, severe tiredness, a build-up of fluid in the abdomen, shortness of breath, and bleeding easily.

What happens if you keep drinking with decompensated cirrhosis? ›

For those patients with decompensated cirrhosis who no longer drink alcohol, they have a life expectancy of more than 50%, but this falls to less than 30% if they continue to consume alcohol[1].

What are the four warning signs of a dying liver? ›

The most common symptoms are jaundice, nausea, fatigue, and pain on the right side of the abdomen. If you think you may be experiencing signs of liver disease, see a healthcare provider right away. National Institute of Diabetes and Digestive and Kidney Disease.

What part of the body itches with liver problems? ›

Itching associated with liver disease tends to be worse in the late evening and during the night. Some people may itch in one area, such as a limb, the soles of their feet, or the palms of their hands, while others experience an all-over itch.

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