We read with interest the paper by Calvaruso and colleagues discussing the role of coagulation in fibrosis in chronic liver disease.1 Fibrotic diseases, and especially liver fibrosis, are a major public health issue, and remain too often refractory to therapy. Novel treatment options are therefore eagerly awaited. Overall, we agree with the author’s conclusions that compelling evidence supports a close relationship between thrombin and hepatic fibrogenesis and that targeting the coagulation cascade might be an attractive therapeutic avenue for the management of liver fibrosis. This notion is underscored by the fact that anticoagulant therapy already showed promise in idiopathic pulmonary fibrosis where it improved overall survival.2

Although we would …