PBS---is characterized by 90% of patients who have anti-mitochondrial antibodies (AMAs) against pyruvate dehydrogenase complex (PDC-E2), an enzyme complex that is found in the mitochondria. Those 'negative' for AMAs are usually found to be positive when more sensitive methods of detection are used. These complex attacks biliary tree, the drainage pipes in Liver-----leads to obstruction and retention of bile----leads to sclerosing cholangitis and liver cancer.
No, not the same piece of the pie for multiple reasons.
1) Mechanism of action of each drug is totally different and unique.
2) And also the indications which go along with each drugs mechanism of action, obeticholic acid is very specifically developed for Primary Biliary Cirrhosis which is a unique autoimmune disease has nothing to do with Obesity or Alcohol, in which your own body produce antibodies to liver. Where as Emricasan, an orally active pan-caspase protease inhibitor mostly tested in patients with NASH and Hepatitis C patients.
e approval of Gilead’s Sovaldi in December 2013 for oral treatment of hepatitis C (HCV) represented a major medical breakthrough. Not only did it provide HCV-infected patients with a vastly more effective treatment Toption than traditional interferon-based therapies, but Sovaldi was also curative in many cases.
The HCV market has only expanded since then as Gilead introduced Harvoni, followed by AbbVie’s VieKira Pak and Merck’s new drug Zepatier.
This period will likely be remembered as a watershed moment for hepatitis C, which affects 150 million people worldwide and kills half a million people each year.
However, patients who have been treated for hep C often have leftover scarring or liver fibrosis. This can lead to long-lasting consequences, according to Steve J. Mento, co-founder and president of Conatus Pharmaceuticals.
“I think the antivirals are doing a tremendous job,” he said. “But there is a huge unmet medical need associated with liver fibrosis, nonalcoholic steatohepatitis (NASH) and cirrhosis. There are no treatments available to treat these conditions.”
An unmet medical need no one talks about
The main consequences of liver disease are increased inflammation and excessive liver cell apoptosis—two processes which can ultimately lead to fibrosis and, eventually, cirrhosis. With cirrhosis, the liver is so scarred it can barely function.
The results are devastating. According to the Global Burden of Disease Study, in 2013, 1.2 million people died from cirrhosis. Liver disease is now the 12th leading cause of death in the U.S. and in 2012 there were 6,000 liver transplants. Ten thousand more are on waiting lists.
Yet, there are no pharmacologic treatments for liver inflammation and fibrosis. Patients are told to improve their diet, exercise more, and stop drinking. It’s palliative care at best.
As Mento said, “Not a lot of people talk about cirrhosis, because there are no treatments out there. Hepatologists want a drug for these patients.”