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imarina_12474_9458036_91473_Hemodynamic profile of terlipressin and octreotide.pdf (2.8 MB)

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2025-01-11

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cc-by-nc-nd (c) Perez Campuzano, Valeria et al., 2025
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/219391

Hemodynamic profile of terlipressin and octreotide in patients with cirrhosis and portal hypertension: A randomized, single-blind clinical trial

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https://doi.org/10.1016/j.jhepr.2024.101325

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Background and aims Continuous infusion (CI) of terlipressin may result in a more sustained reduction in portal pressure with fewer adverse effects than administered as a bolus. This study aimed to compare the hepatic and cardiopulmonary hemodynamic effects and safety profiles of bolus vs terlipressin CI. Methods This is a single-center, single-blinded, double-dummy, parallel-group, clinical trial in which 38 patients with cirrhosis and portal hypertension were randomized to receive: 1mg bolus of terlipressin + CI of placebo (TERLBOL n=12), bolus of placebo + CI of terlipressin (2mg/day or 4mg/day if <10% reduction in hepatic venous pressures gradient (HVPG) at 30min of infusion) (TERLINF n=14) or a bolus of octreotide (50mcg) + CI of octreotide (50mcg/h) (OCTR n=12) as an additional control group. HVPG, cardiopulmonary pressures and cardiac output were measured at baseline, after 30, 60 and 120 minutes. Results Sixty-eight percent of patients were male, with median age 59-years. There were no significant differences in baseline characteristics. TERLBOL group: there was a non-significant reduction in HVPG (at 120min, -4.9%; p:0.14), however, cardiopulmonary and mean arterial pressures significantly increased, while cardiac output and heart rate significantly decreased. TERLINF group: there were non-significant changes in cardiopulmonary hemodynamics or HVPG (NS) despite doubling the infusion dose after 30min in 13/14 patients. OCTR group: there was a non-significant reduction in HVPG (at 120min, -4.9%; p:0.08) and pulmonary capillary pressure significantly decreased. All treatments were well tolerated, and no adverse events were observed. Conclusion There were non-significant reductions in HVPG with the three therapeutic strategies. Further investigations are warranted to determine the optimal dosing strategy for CI of Terlipressin in patients with cirrhosis and portal hypertension.

Matèries

Hipertensió portal, Cirrosi hepàtica

Matèries (anglès)

Portal hypertension, Hepatic cirrhosis

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Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

PEREZ CAMPUZANO, Valeria, OLIVAS, Pol, FERRUSQUIA ACOSTA, José, TORRES, Sonia, BORRAS, Roger, BAIGES AZNAR, Anna, ORTS, Lara, VIZCARRA, Pamela, FALGA, María ángeles, CODINA, Joana, SHALABY, Sarah, OJEDA GÓMEZ, Asunción, TURON, Fanny, HERNÁNDEZ GEA, Virginia, CÁRDENAS VÁSQUEZ, Andrés, GARCÍA PAGÁN, Juan carlos. Hemodynamic profile of terlipressin and octreotide in patients with cirrhosis and portal hypertension: A randomized, single-blind clinical trial. _JHEP Reports_. 2025. Vol.  101325. [consulta: 25 de febrer de 2026]. ISSN: 2589-5559. [Disponible a: https://hdl.handle.net/2445/219391]

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