Hepatic Encephalopathy Market Set to Grow Through 2030 as Golexanolone and AXA1665 Advance Through Clinical Development

DelveInsight's "Hepatic Encephalopathy (HE) - Market Insights, Epidemiology, and Market Forecast - 2030" report delivers an in-depth understanding of hepatic encephalopathy, historical and forecasted epidemiology, and market trends in the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.

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Some of the Key Facts of the Hepatic Encephalopathy Market Report
• The market size of hepatic encephalopathy across the 7MM was USD 1,448 million in 2020, expected to grow at a CAGR of 5.31% through 2030.
• Total diagnosed prevalent cases of hospitalized cirrhosis across the 7MM stood at 860,784 in 2020, projected to grow at a CAGR of 0.63% through 2030, with diagnosed HE cases expected to grow at a CAGR of 0.61% over the same period.
• The United States carries the highest diagnosed prevalent HE burden among the 7MM, with 205,018 cases in 2020, including 149,048 male and 55,970 female cases; the 45-54 age group is most affected.
• In the US in 2020, there were 123,011 covert HE (CHE) cases and 82,007 overt HE (OHE) cases.
• Among the EU5, the United Kingdom led with 27,556 cases in 2020, followed by Germany (26,672) and France (22,276), while Spain recorded the fewest at 9,808; Germany posted the largest EU5 market size at USD 45 million, while Spain's was the smallest at USD 16 million.
• Japan recorded 29,571 diagnosed prevalent HE cases in 2020, with cases expected to grow at a CAGR of 0.20% through 2030.
• Xifaxan (Rifaximin) remains the primary approved therapy for reducing OHE recurrence, while emerging candidates AXA1665 (Axcella Health) and golexanolone/GR3027 (Umecrine Cognition) are advancing through Phase II and Phase I/IIa development, respectively.

Key Hepatic Encephalopathy Companies
• Salix Pharmaceuticals/Bausch Health
• Axcella Health
• Umecrine Cognition
• Others

Key Hepatic Encephalopathy Therapies
• Xifaxan (Rifaximin)
• AXA1665
• Golexanolone (GR3027)
• Others
The hepatic encephalopathy market is expected to see steady growth driven by rising diagnosed prevalence, an aging cirrhotic population, and an expanding pipeline of therapies targeting gut bacteria and neurosteroid pathways beyond the decades-old standard of non-absorbable disaccharides and antibiotics. The continued development of golexanolone, AXA1665, and other emerging candidates is expected to reshape the competitive landscape over the forecast period.

Hepatic Encephalopathy Overview
Hepatic encephalopathy (HE) is a brain disorder that develops in some individuals with liver disease, characterized by:
• A spectrum of neuropsychiatric symptoms ranging from subtle, fluctuating cognitive impairment to coma.
• Classification as Type A, B, or C depending on association with acute liver failure, liver bypass/shunt procedures, or cirrhosis.
• Pathogenesis linked to ammonia and glutamine production, with many symptoms reversible when promptly detected and treated.
HE can present as covert (CHE), with no outward clinical signs but detectable neuropsychological deficits, or overt (OHE), with obvious outward symptoms including reduced alertness, shortened attention span, disrupted sleep, mild confusion, and mood or personality changes. Diagnosis is challenging, particularly for CHE, and relies on identifying neuropsychiatric abnormalities in patients with liver dysfunction after excluding unrelated neurologic or metabolic causes, often supported by psychometric or neuropsychological testing.

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Hepatic Encephalopathy Market Segmentation
The hepatic encephalopathy market report proffers detailed analysis for the study period 2018-2030 segmented into:
By Region/Geography
• North America (US)
• Europe (Germany, France, Italy, Spain, and the UK)
• Asia-Pacific (Japan)
By Drugs/Therapies
By Epidemiology Segmentation
• Total diagnosed prevalent cases of hepatic encephalopathy
• Gender-specific diagnosed prevalent cases
• Age-specific diagnosed prevalent cases
• Type-specific (covert/overt) diagnosed prevalent cases

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Hepatic Encephalopathy Treatment Landscape
Management of HE centers on correcting or removing precipitating causes, dietary changes, and pharmacologic approaches, with treatment options largely unchanged over the past 40 years:
• Standard care for overt HE (OHE) relies on the two primary forms of medical therapy - non-absorbable disaccharides (lactitol and lactulose) and non-absorbable antibiotics (Rifaximin) - alongside identifying and managing precipitating factors and preventing recurrence.
• Xifaxan (Rifaximin), marketed by Salix Pharmaceuticals/Bausch Health, is FDA-approved to reduce the risk of OHE recurrence in patients 18 and older, and the company continues exploring additional indications and formulations.
• Covert HE (CHE) is rarely recognized or treated outside clinical trials given the lack of clinical signs; first-line management is a 4- to 8-week trial of lactulose, with Rifaximin's high cost limiting its use in CHE.
• AXA1665 (Axcella Health), a composition of eight amino acids and derivatives targeting metabolic pathways across the liver, muscle, and gut, is in Phase II development to reduce OHE recurrence risk in adults with liver cirrhosis.
• Golexanolone (GR3027) (Umecrine Cognition, a Karolinska Development company) is an oral GABAA-receptor modulating steroid antagonist (GAMSA) in Phase I/IIa development for covert HE.

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Hepatic Encephalopathy Market Strengths
• Xifaxan provides a well-established, FDA-approved option for reducing OHE recurrence, with ongoing exploration of new formulations and indications.
• A robust pipeline with novel mechanisms of action and oral routes of administration - including gut-targeted and neurosteroid-based approaches - signals growing pipeline maturity.
• Rising diagnosed prevalence and improved recognition of both covert and overt HE are expanding the addressable treated population.

Hepatic Encephalopathy Market Opportunities
• The lack of dedicated, cost-effective options for covert HE represents a significant unmet need and market entry opportunity.
• Persistent gaps in HE diagnosis, particularly for CHE, alongside high treatment costs, are driving demand for more accessible and durable therapies.

Scope of the Hepatic Encephalopathy Market Report
• Study Period: 2018-2030
• Forecast Period: 2021-2030
• Coverage: The US; Germany, France, Italy, and Spain (EU4), and the UK (EU5); Japan
• Key Companies: Salix Pharmaceuticals/Bausch Health, Axcella Health, Umecrine Cognition, and others
• Key Therapies: Xifaxan (Rifaximin), AXA1665, Golexanolone (GR3027), and others
• Market CAGR (Forecast Period): 5.31% (2018-2030)
• Analysis Includes: KOL views, SWOT analysis, PESTLE analysis, Porter's Five Forces, BCG Matrix, reimbursement, unmet needs, market drivers and barriers, epidemiology patient burden

To know more about hepatic encephalopathy companies working in the market, visit:
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Table of Contents
1. Hepatic Encephalopathy Market Report Introduction
2. Executive Summary for Hepatic Encephalopathy
3. SWOT Analysis of Hepatic Encephalopathy
4. Hepatic Encephalopathy Market Overview at a Glance
5. Hepatic Encephalopathy Disease Background and Overview
6. Hepatic Encephalopathy Market Segmentation and Analysis
7. Regional Analysis of the Hepatic Encephalopathy Market
8. Country-Specific Hepatic Encephalopathy Market Analysis
9. Competitive Landscape and Key Company Profiles
10. Hepatic Encephalopathy Unmet Needs
11. Hepatic Encephalopathy Emerging Therapies and Pipeline
12. Hepatic Encephalopathy Market Outlook
13. Hepatic Encephalopathy Market Access and Reimbursement
14. Hepatic Encephalopathy Market Drivers
15. Hepatic Encephalopathy Market Barriers
16. Hepatic Encephalopathy Recent Developments
17. Hepatic Encephalopathy Appendix
18. Hepatic Encephalopathy Report Methodology
19. DelveInsight Capabilities
20. Disclaimer
21. About DelveInsight

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