In decompensated cirrhosis, the liver is severely scarred, leading to poor blood flow and complications like low blood pressure and kidney dysfunction. One major issue is hemodynamic dysfunction where blood vessels in the abdomen become too relaxed, causing blood to pool around abdominal organs instead of circulating properly. This can worsen problems like hepatorenal syndrome (an acute and life-threatening type of kidney failure) and fluid buildup in the belly (ascites).

The Vasopressin/V1a axis is a clinically validated pathway to address hemodynamic dysfunction. V1a receptor agonists stimulate V1a receptors on abdominal smooth muscle causing vasoconstriction and redirecting pooled blood back into the general circulation.  This increases systemic blood pressure and improves blood supply to the kidneys. By inducing vasoconstriction and improved circulatory function, PHIN-214 aims to reestablish hemodynamic balance, reduce fluid retention, and improve organ perfusion, addressing multiple complications of disease in patients with decompensated cirrhosis.