Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome

• Published in: The New England journal of medicine Vol. 384; no. 9; pp. 818 - 828
• Main Authors: Wong, Florence, Pappas, S. Chris, Curry, Michael P, Reddy, K. Rajender, Rubin, Raymond A, Porayko, Michael K, Gonzalez, Stevan A, Mumtaz, Khalid, Lim, Nicholas, Simonetto, Douglas A, Sharma, Pratima, Sanyal, Arun J, Mayo, Marlyn J, Frederick, R. Todd, Escalante, Shannon, Jamil, Khurram
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 04.03.2021
• Subjects: Adverse events; Albumin; Albumins - therapeutic use; Ascites; Cardiovascular disease; Cirrhosis; Clinical practice guidelines; Combined Modality Therapy; Consent; Creatinine; Diarrhea; Double-Blind Method; Female; Hemodynamics; Hepatorenal Syndrome - drug therapy; Hepatorenal Syndrome - etiology; Hepatorenal Syndrome - mortality; Humans; Inflammation; Infusions, Intravenous; Liver; Liver cirrhosis; Liver Cirrhosis - complications; Liver Transplantation; Male; Middle Aged; Mortality; Nausea; Patients; Placebos; Renal function; Renal Replacement Therapy; Respiratory failure; Respiratory Insufficiency - chemically induced; Success; Systemic inflammatory response syndrome; Terlipressin - adverse effects; Terlipressin - therapeutic use; Treatment Outcome; Vasoconstrictor Agents - adverse effects; Vasoconstrictor Agents - therapeutic use
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa2008290

In a phase 3 randomized trial, 199 patients with type 1 hepatorenal syndrome were assigned to receive the vasoconstrictor terlipressin plus albumin and 101 to receive placebo plus albumin. Renal function was better with terlipressin than with placebo; however, mortality was not lower, and terlipressin was associated with adverse events, including respiratory failure.