Terlipressin in the treatment of type one hepatorenal syndrome: a systematic review and meta-analysis

Abstract

Abstract: Objective Hepatorenal syndrome is a fatal complication of the decompensated stage of cirrhosis. Terlipressin is the most widely used treatment method, however, the therapy effects remains inconsonant. We aim to systematically assess the safety and efficacy of terlipressin in the treatment type 1 hepatorenal syndrome.Methods We conducted a systematic review and meta-analysis. Randomized controlled trials form databases such as PubMed and Embase involving terlipressin for hepatorenal syndrome were included in a systematic literature search. Two authors independently assessed the studies for inclusion and extracted the data. A meta-analysis was conducted to estimate the safety and efficacy of terlipressin for hepatorenal syndrome. Results A total of 13 randomized controlled trials including 746 patients were included. These studies included 5 studies comparing with placebo, 6 studies comparing with noradrenaline, one comparing with dopamine and one comparing with octreotide. The total hepatorenal syndrome reverse rate was 33.7% and the total mortality was 60.1%. Terlipressin had greater hepatorenal syndrome reverse (RR=2.13, 95%CI: 1.26-3.61, P=0.005, I² =51%) and more adverse events (RR=2.05, 95%CI: 1.36-3.09, P=0.0006, I² =0%) than the control group in the management of type 1 hepatorenal syndrome. The subgroup analysis showed that terlipressin had superiority comparing to placebo, but the safety and efficacy was similar when comparing with norepinephrine.Conclusion Terlipressin was one of the most effective drugs for management of type 1 hepatorenal syndrome.

Key words: Adverse event, Hepatorenal syndrome, Hepatorenal syndrome reverse, Terlipressin

DONG Xin-xin, WANG Hai-qing, WANG Xing-chun.. Terlipressin in the treatment of type one hepatorenal syndrome: a systematic review and meta-analysis[J]. Chinese Hepatolgy, 2020, 25(3): 254-259.

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