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AXA1665 is an investigational, orally administered multi-component endogenous metabolic modulator (EMM) composition developed by Axcella Health for the treatment of complications associated with liver cirrhosis, including overt hepatic encephalopathy (OHE) and sarcopenia. It consists of a proprietary ratio of eight amino acids: the branched-chain amino acids (leucine, isoleucine, and valine), other essential amino acids (histidine, lysine, and threonine), and the urea cycle amino acids L-ornithine and L-aspartate. AXA1665 is designed to address the core metabolic derangements of cirrhosis by reducing hyperammonemia through urea cycle activation and correcting amino acid imbalances (specifically increasing the Fischer ratio). Furthermore, it aims to stimulate muscle protein synthesis via the mTORC1 pathway to improve muscle mass and physical function, as measured by the Liver Frailty Index.
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