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

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 terlipress...

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Autores: Perez Campuzano, Valeria, Olivas, Pol, Ferrusquia Acosta, José, Torres, Sonia, Borràs, 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
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2025
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/219391
Acceso en línea:https://hdl.handle.net/2445/219391
Access Level:acceso abierto
Palabra clave:Hipertensió portal
Cirrosi hepàtica
Portal hypertension
Hepatic cirrhosis
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spelling Hemodynamic profile of terlipressin and octreotide in patients with cirrhosis and portal hypertension: A randomized, single-blind clinical trialPerez Campuzano, ValeriaOlivas, PolFerrusquia Acosta, JoséTorres, SoniaBorràs, RogerBaiges Aznar, AnnaOrts, LaraVizcarra, PamelaFalga, María ÁngelesCodina, JoanaShalaby, SarahOjeda Gómez, AsunciónTuron, FannyHernández Gea, VirginiaCárdenas Vásquez, AndrésGarcía Pagán, Juan CarlosHipertensió portalCirrosi hepàticaPortal hypertensionHepatic cirrhosisBackground 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.2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/219391Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésVersió postprint del document publicat a: https://doi.org/10.1016/j.jhepr.2024.101325JHEP Reports, 2025, 101325https://doi.org/10.1016/j.jhepr.2024.101325cc-by-nc-nd (c) Perez Campuzano, Valeria et al., 2025http://creativecommons.org/licenses/by-nc-nd/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2193912026-05-27T06:46:51Z
dc.title.none.fl_str_mv Hemodynamic profile of terlipressin and octreotide in patients with cirrhosis and portal hypertension: A randomized, single-blind clinical trial
title Hemodynamic profile of terlipressin and octreotide in patients with cirrhosis and portal hypertension: A randomized, single-blind clinical trial
spellingShingle Hemodynamic profile of terlipressin and octreotide in patients with cirrhosis and portal hypertension: A randomized, single-blind clinical trial
Perez Campuzano, Valeria
Hipertensió portal
Cirrosi hepàtica
Portal hypertension
Hepatic cirrhosis
title_short Hemodynamic profile of terlipressin and octreotide in patients with cirrhosis and portal hypertension: A randomized, single-blind clinical trial
title_full Hemodynamic profile of terlipressin and octreotide in patients with cirrhosis and portal hypertension: A randomized, single-blind clinical trial
title_fullStr Hemodynamic profile of terlipressin and octreotide in patients with cirrhosis and portal hypertension: A randomized, single-blind clinical trial
title_full_unstemmed Hemodynamic profile of terlipressin and octreotide in patients with cirrhosis and portal hypertension: A randomized, single-blind clinical trial
title_sort Hemodynamic profile of terlipressin and octreotide in patients with cirrhosis and portal hypertension: A randomized, single-blind clinical trial
dc.creator.none.fl_str_mv Perez Campuzano, Valeria
Olivas, Pol
Ferrusquia Acosta, José
Torres, Sonia
Borràs, 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
author Perez Campuzano, Valeria
author_facet Perez Campuzano, Valeria
Olivas, Pol
Ferrusquia Acosta, José
Torres, Sonia
Borràs, 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
author_role author
author2 Olivas, Pol
Ferrusquia Acosta, José
Torres, Sonia
Borràs, 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
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Hipertensió portal
Cirrosi hepàtica
Portal hypertension
Hepatic cirrhosis
topic Hipertensió portal
Cirrosi hepàtica
Portal hypertension
Hepatic cirrhosis
description 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.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/219391
url https://hdl.handle.net/2445/219391
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1016/j.jhepr.2024.101325
JHEP Reports, 2025, 101325
https://doi.org/10.1016/j.jhepr.2024.101325
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Perez Campuzano, Valeria et al., 2025
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Perez Campuzano, Valeria et al., 2025
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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