PMID- 34386597
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220425
IS  - 2397-9070 (Electronic)
IS  - 2397-9070 (Linking)
VI  - 5
IP  - 8
DP  - 2021 Aug
TI  - Terlipressin effect on hepatorenal syndrome: Updated meta-analysis of randomized 
      controlled trials.
PG  - 896-901
LID - 10.1002/jgh3.12600 [doi]
AB  - BACKGROUND AND AIM: Hepatorenal syndrome (HRS) is a fatal complication of liver 
      cirrhosis with a limited pharmacological option. Terlipressin is a 
      vasoconstrictor that is approved in many countries but not yet in the United 
      States. This is a meta-analysis of randomized controlled trials (RCTs) to review 
      terlipressin effect on HRS and the safety profile. METHODS: We searched 
      electronic databases for RCTs comparing terlipressin versus placebo in addition 
      to albumin in patients with type 1 or 2 HRS. Primary outcome was HRS reversal. 
      Secondary outcomes were change in serum creatinine (Cr), requirement for renal 
      replacement therapy (RRT) at 30 days of randomization, and 90-day survival. Risk 
      ratios (RRs) and mean differences (MD) were calculated with 95% confidence 
      intervals (CIs) using a random-effects model. RESULTS: We identified eight RCTs 
      with a total of 974 patients, and median follow up of 100 days. Mean age was 
      55 +/- 10 years, 61% were males. Alcoholic liver disease represented 56%. Compared 
      with placebo, terlipressin was associated with a significantly higher likelihood 
      of HRS reversal (RR 2.08; 95% CI [1.51, 2.86], P < 0.001), significantly lower 
      serum Cr (MD -0.64; 95% CI (-1.02, -0.27), P < 0.001], and a trend toward less 
      RRT requirements (RR 0.61; 95% CI [0.36, 1.02], P = 0.06). There was no 
      difference in survival at 90 days between groups (RR 1.09; 95% CI (0.84, 1.43), 
      P = 0.52). Major adverse effects (AEs) were gastrointestinal cramps, discomfort, 
      and respiratory distress. CONCLUSION: In patients with liver cirrhosis 
      complicated by HRS, terlipressin was associated with significant HRS reversal and 
      decrease in serum Cr. No survival benefit was detected at 90 days.
CI  - (c) 2021 The Authors. JGH Open published by Journal of Gastroenterology and 
      Hepatology Foundation and John Wiley & Sons Australia, Ltd.
FAU - Mohamed, Mohamed M G
AU  - Mohamed MMG
AUID- ORCID: 0000-0002-7514-7811
AD  - Internal Medicine Department SSM Health St. Mary's Hospital-St. Louis St. Louis 
      Missouri USA.
FAU - Rauf, Abdul
AU  - Rauf A
AD  - Internal Medicine Department SSM Health St. Mary's Hospital-St. Louis St. Louis 
      Missouri USA.
FAU - Adam, Abubakr
AU  - Adam A
AD  - Hospital Medicine Department, School of Medicine University of Missouri Colombia 
      Missouri USA.
FAU - Kheiri, Babikir
AU  - Kheiri B
AD  - Department of Cardiology, Knight Cardiovascular Institute Oregon Health & Science 
      University Portland Oregon USA.
FAU - Lacasse, Alexandre
AU  - Lacasse A
AD  - Internal Medicine Department SSM Health St. Mary's Hospital-St. Louis St. Louis 
      Missouri USA.
FAU - El-Halawany, Hani
AU  - El-Halawany H
AD  - Department of Gastroenterology, Hepatobiliary and Endoscopy SSM Health St. Mary's 
      Hospital-St. Louis St. Louis Missouri USA.
LA  - eng
PT  - Journal Article
DEP - 20210701
PL  - Australia
TA  - JGH Open
JT  - JGH open : an open access journal of gastroenterology and hepatology
JID - 101730833
PMC - PMC8341180
OTO - NOTNLM
OT  - albumin
OT  - cirrhosis
OT  - hepatorenal syndrome
OT  - terlipressin
EDAT- 2021/08/14 06:00
MHDA- 2021/08/14 06:01
PMCR- 2021/07/01
CRDT- 2021/08/13 07:13
PHST- 2021/05/08 00:00 [received]
PHST- 2021/06/05 00:00 [revised]
PHST- 2021/06/11 00:00 [accepted]
PHST- 2021/08/13 07:13 [entrez]
PHST- 2021/08/14 06:00 [pubmed]
PHST- 2021/08/14 06:01 [medline]
PHST- 2021/07/01 00:00 [pmc-release]
AID - JGH312600 [pii]
AID - 10.1002/jgh3.12600 [doi]
PST - epublish
SO  - JGH Open. 2021 Jul 1;5(8):896-901. doi: 10.1002/jgh3.12600. eCollection 2021 Aug.