Terlipressin given by continuous i.v. infusion versus i.v. boluses in the treatment of hepatorenal syndrome: A randomized controlled study.
Hepatology. 2015 Dec 13;
Authors: Cavallin M, Piano S, Romano A, Fasolato S, Chiara Frigo A, Benetti G, Gola E, Morando F, Stanco M, Rosi S, Sticca A, Cillo U, Angeli P
BACKGROUND: In patients with cirrhosis and hepatorenal syndrome (HRS), terlipressin has been used either as continuous i.v. infusion or as i.v. boluses. Up to now these two schedules have never been compared.
AIM: To compare administration of terlipressin as continuous i.v. infusion versus i.v. boluses in the treatment of type 1 HRS.
METHODS: Seventy-eight patients were randomized to receive either continuous i.v. infusion (TERLI-INF Group) at the initial dose of 2 mg/24 hr or i.v. boluses of terlipressin (TERLI-BOL Group) at the initial dose of 0.5 mg/4 hr. In case of no response, the dose was progressively increased up to a final dose of 12 mg/day in both Groups. Albumin was given at the same dose in both Groups (1 g/kg of body weight at the first day followed by 20-40 g/day). Complete response was defined by decrease of serum creatinine (sCr) from baseline to a final value ≤133 μmol/L, partial response by a decrease ≥50% of sCr from baseline to a final value >133 μmol/L.
RESULTS: The rate of adverse events was lower in TERLI-INF Group (35.29%) than in TERLI-BOL Group (62.16%, p < 0.025). The rate of response to treatment, including both complete and partial response, was not significantly different in the two Groups (76.47% vs 64.85%, P = N.S.). The mean daily effective dose of terlipressin was lower in TERLI-INF Group than in TERLI-BOL Group (2.23 ± 0.65 vs 3.51 ± 1.77 mg/day, p < 0.05).
CONCLUSIONS: Terlipressin given by continuous i.v. infusion is better tolerated than i.v. boluses in the treatment of type 1 HRS. Moreover it is effective at lower doses than those provided for its administration by i.v. boluses. This article is protected by copyright. All rights reserved.
PMID: 26659927 [PubMed - as supplied by publisher]