Terlipressin effective in GE variceal bleeding and hepatorenal syndrome in liver cirrhosis

Recent Practice Guidance has supported the use of Terlipressin for gastroesophageal variceal bleeding and hepatorenal syndrome (HRS) in liver cirrhosis as per a study that was published in the journal Therapeutic Advances in Gastroenterology. 

Liver cirrhosis has a high risk of morbidity and mortality and is a major global health burden worldwide. Lately, terlipressin has been prescribed for the management of liver cirrhosis–related complications. Hence researchers from the Chinese Society of Gastroenterology conducted a study to develop evidence-based clinical practice guidance on the use of terlipressin for liver cirrhosis–related complications. The clinical practice guidance based on a comprehensive literature review and experts' clinical experiences was formulated by the gastroenterologists, hepatologists, infectious disease specialists, surgeons, and clinical pharmacists invited by the Hepatobiliary Study Group of the Chinese Society of Gastroenterology of the Chinese Medical Association and Hepatology Committee of the Chinese Research Hospital Association. 

Results:

• 10 major guidance statements regarding the efficacy and safety of terlipressin in liver cirrhosis were proposed.
• Terlipressin can be advantageous and hence recommended in the management of acute variceal bleeding and hepatorenal syndrome (HRS) in cirrhotic patients.
• It should be considered in acute gastrointestinal bleeding patients with liver cirrhosis before endoscopy and in cirrhotic patients with acute gastrointestinal bleeding and renal dysfunction.
• There is insufficient evidence regarding the use of terlipressin in cirrhotic patients with ascites, post-paracentesis circulatory dysfunction, bacterial infections, and those undergoing hepatic resection and liver transplantation.
• Terlipressin-related adverse events, mainly including gastrointestinal symptoms, electrolyte disturbance, and cardiovascular and respiratory adverse events, should be closely monitored.  

Thus, the researchers put forth from their clinical practice guidance that terlipressin is beneficial for gastroesophageal variceal bleeding and HRS in liver cirrhosis but suggested high-quality studies to further clarify its potential effects in other liver cirrhosis–related complications. 

For further reading, click here: 10.1177/17562848221098253

Qi X, Bai Z, Zhu Q, et al. Practice guidance for the use of terlipressin for liver cirrhosis-related complications. Therap Adv Gastroenterol. 2022;15:17562848221098253. Published 2022 May 18.