A promising dietary supplement commonly used for muscle development is being investigated as a potential breakthrough treatment for chronic liver disease. The BOOST study, launching across multiple UK hospitals, will examine whether β-hydroxy β-methylbutyrate (HMB) can provide relief for thousands of cirrhosis patients currently facing limited treatment options.
The £500,000 research initiative, funded by the National Institute for Health and Care Research (NIHR), brings together experts from the University of Plymouth, University of Southampton, and Imperial College London to explore HMB's therapeutic potential through 2027.
Understanding the Clinical Need
Cirrhosis affects approximately 60,000 people in the UK, primarily resulting from harmful alcohol use or fatty liver disease. The condition, characterized by liver scarring, leads to over 75,000 hospital admissions annually and costs the National Health Service an estimated £17 billion. Current treatment options are largely limited to liver transplantation or symptomatic management.
"Cirrhosis is a condition that can have a significant impact on a person's physical and mental wellbeing," explains Dr. Ashwin Dhanda, Associate Professor in Hepatology at the University of Plymouth and the study's Chief Investigator. "While there are treatments in development, at the moment there is nothing we can prescribe that directly addresses the condition."
Trial Design and Methodology
The BOOST study will recruit 124 patients from eight hospital outpatient clinics across England, with a particular focus on deprived areas where cirrhosis rates are higher. The trial design includes:
- 12-week treatment period with HMB or placebo administered twice daily
- 12-week follow-up period for monitoring outcomes
- Assessment using the Liver Frailty Index
- Evaluation of liver disease progression
- Quality of life and mental wellbeing measurements
Patient-Centered Approach
The research team has actively incorporated patient perspectives into the trial design. Lesley Manning, a liver transplant recipient with lived experience of advanced cirrhosis, serves on the project team to ensure patient voices are heard throughout the study.
"Living with advanced cirrhosis is very debilitating. It makes you feel like you have no energy or strength, and there are no treatments out there to help manage your symptoms," Manning shares. "The BOOST trial is testing something simple and safe that may improve the quality of life of people with advanced cirrhosis."
Scientific Promise and Future Impact
HMB's established safety profile and previous clinical applications make it an attractive candidate for treating cirrhosis. The supplement, traditionally used for muscle building and preventing muscle loss, could potentially offer a new therapeutic avenue for patients who currently have few treatment options.
The trial will be managed by the Peninsula Clinical Trials Unit (PenCTU), with support from the University's Hepatology Research Group and NIHR ARC South West Peninsula (PenARC). Results from this comprehensive study could potentially transform the treatment landscape for cirrhosis patients, offering a safe and accessible therapeutic option for managing this challenging condition.
