Table 1.
General characteristics of the selected studies on vasoconstrictor pharmacotherapy in HRS
| Study (Year, Country) |
HRS Type |
Study design | Age; sexz |
Drug tested | Colloid used (dose) |
Cohort as reported and entered in the analysis |
No. per arm |
Baseline MAP (mm Hg)b |
Baseline SCr (mg/dL)b |
Duration of therapy (d) |
Child- Pugh; MELD |
Alcoholism as cause of liver failure (%) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Guevara41 (1998, ES) | 1 | Prospective, uncontrolled | 53 [27-72] y; 75% M | Ornipressin | Alb (1 g/kg; 20-60 g/d)a | 3-d vs 15-d course | 8 vs 8 | 72 ± 4 vs 69 ± 3 | 2.9 ± 0.5 vs 3.0 ± 0.5 | 3 vs 15 | NA; NA | 38 |
| Gulberg42 (1999, DE) | 1 | Prospective, uncontrolled | 50 ± 5 y; 67% M | Ornipressin | Alb (6-8 ascites) | Responders vs nonresponders | 5 vs 4 | 70 ± 2 vs 78 ± 4 | 4.6 ± 0.9 vs 2.1 ± 0.2 | 14c vs 14c | 12; NA | 56 |
| Angeli36 (1999, IT) | 1 | Prospective, nonrandomized, controlled | 61 ± 3 y; NA | Dopamine; midodrine + octreotide | Alb (40 g/d) | Dopamine- vs midodrine- + octreotide-treated | 8 vs 5 | 79 ± 4 vs 76 ± 3 | 3.6 ± 0.6 vs 5.0 ± 0.8 | 10 vs 10 | Cy; NA | 40 |
| Uriz38 (2000, ES) | 1,2 | Prospective, uncontrolled | 54 [42-75] y; 67% M | Terlipressin | Alb (1 g/kg; 20-40 g/d)a | Terlipressin-treated | 9 | 68 ± 2 | 3.9 ± 0.7 | 9c | NA; NA | 44 |
| Mulkay37 (2001, BE) | 1 | Prospective, uncontrolled | 54 [45-60] y; 83% M | Terlipressin | Alb (60 g/d) | Terlipressin-treated | 12 | 76 [68-83] | 3.4 [2.5-4.0] | 14 | 10; NA | 75 |
| Ortega (2002, ES) | 1,2 | Pospective, nonrandomized, controlled | 57 ± 2 y; 67% M | Terlipressin; terlipressin + albumin | Alb (1 g/kg; 20-40 g/d)a | Terlipressin-vs terlipressin- + albumin-treated | 8 vs 13 | 64 ± 4 vs 70 ± 2 | 3.4 ± 0.3 vs 3.6 ± 0.5 | 7c vs 7c | 10.6; NA | 43 |
| Duvoux (2002, FR) | 1 | Prospective, uncontrolled | 54 ± 5 y; 58% M | Norepinephrine | Alb (22 g/d) | Norepinephrine-treated | 12 | 65 ± 7 | 4.0 ± 1.8 | 10c | 11.3; NA | 67 |
| Halimi (2002, FR) | 1,2 | Retrospective, uncontrolled | 60 ± 2 y; 61% M | Terlipressin | NA | Responders vs nonresponders | 13 vs 5 | 84 ± 4 vs 76 ± 6 | 2.7 ± 1.0 vs 2.9 ± 0.8 | 5 vs 5 | 11.2; NA | 78 |
| Colle (2002, FR) | 1 | Retrospective, uncontrolled | 47 ± 2 y; 94% M | Terlipressin | Alb (20 g/d) in 13/18 cases | Responders vs nonresponders | 11 vs 7 | 74 ± 6 vs 79 ± 6 | 3.1 ± 0.5 vs 3.3 ± 1.0 | 9c vs 9c | 12.6; NA | 72 |
| Alessandria (2004. IT) | 2 | Prospective, uncontrolled | 59 ± 2; 82% M | Terlipressin | Alb (NA) | Terlipressin-treated | 11 | 91 ± 15 | 2.4 ± 0.9 | 7 | NA; NA | 64 |
| Solanki (2003, IN) | 1 | Prospective, randomized, controlled | 52 ± 5 y; 70% M | Terlipressin; placebo | Alb (40 g/d) + FFP | Terlipressin- vs placebo-treated | 12 vs 12 | 76 ± 1 vs 74 ± 1 | 2.9 ± 0.1 vs 2.2 ± 0.2 | 8 vs 8 | NA; NA | 33 |
| Pomier-Layrargues (2003, CA) | 1,2 | Prospective, randomized, crossover | 52 ± 3 y; 75% M | Octreotide; placebo | Alb (50 g/d) | Octreotide- vs placebo-treated | 7 vs 9 | 76 ± 3 vs 83 ± 5 | 2.3 ± 0.2 vs 2.4 ± 0.3 | 4 vs 4 | 12.2; NA | NA |
| Wong (2004, CA) | 1 | Prospective, uncontrolled | 55 ± 3 y; 79% M | Midodrine + octreotide | Alb (50 g/d) | Responders vs nonresponders | 10 vs 4 | 81 ± 5 vs 79 ± 4 | 2.6 ± 0.3 vs 3.9 ± 1.3 | 14c vs 14c | 9.9; NA | 100 |
| Saner (2004, DE) | 1,2 | Prospective, uncontrolled | NA | Terlipressin | GPS | Terlipressin-treated | 7 | 58 ± 4 | 3.9 ± 0.4 | 7 | NA; NA | 14 |
| Alessandria (2007, IT) | 1,2 | Prospective, randomized, controlled | 55 ± 2 y; 73% M | Norepinephrine; terlipressin | Alb (35-75 g/d) | Norepinephrine- vs terlipressin-treated | 10 vs 12 | 71 ± 2 vs 74 ± 3 | 2.3 ± 0.2 vs 2.5 ± 0.3 | 14 vs 14 | 10.5; 26 | 27 |
| Sharma (2008, IN) | 1 | Prospective, randomized, controlled | 48 ± 2 y; 85% M | Norepinephrine; terlipressin | Alb (20-40 g/d) | Norepinephrine- vs terlipressin-treated | 20 vs 20 | 81 ± 2 vs 78 ± 1 | 3.0 ± 0.5 vs 3.3 ± 1.3 | 15 vs 15 | 10.8; 30.6 | 65 |
| Sanyal (2008, US & RU) | 1 | Prospective, randomized, controlled | 52 ± 1 y; 71% M | Terlipressin; placebo | Alb (100 g; 25 g/d)a | Terlipressin- vs placebo-treated | 56 vs 56 | 76 ± 1 vs 77 ± 2 | 3.9 ± 2.1 vs 3.8 ± 1.1 | 6c vs 6c | NA; 33 | 52 |
| Martin-Llahi (2008, ES) | 1,2 | Prospective, randomized, controlled | 57 ± 2 y; 62% M | Terlipressin + Alb; Alb | Alb (1 g/kg; 40 g/d)a | Responders vs nonresponders | 10d vs 13d | 75 ± 4 vs 68 ± 3 | 2.9 ± 0.8 vs 4.0 ± 2.1 | 7c vs 7c | 10.5; 30 | 73 |
| Neri (2008, IT) | 1 | Prospective, randomized, controlled | 60 ± 4 y; 40% M | Terlipressin + Alb; Alb | Alb (1 g/kg; 20-40 g/d)a | Terlipressin + Alb- vs Alb-treated | 26 vs 26 | 68 ± 3 vs 72 ± 2 | 2.9 ± 1.2 vs 2.8 ± 1.1 | 14 vs 14 | 11.4; NA | 13 |
| Munoz (2009, MX) | 1 | Prospective, uncontrolled | 55 ± 6 y; 92% M | Terlipressin | Alb (30-80 g/d) | Responders vs nonresponders | 8 vs 5 | 70 ± 3 vs 69 ± 3 | 3.0 ± 1.7 vs 3.9 ± 1.5 | 12c vs 5c | 11.2; 30 | 31 |
| Nazar (2010, ES) | 1 | Retrospective, uncontrolled | 56 ± 1 y; 74% M | Terlipressin | Alb (1 g/kg; 40 g/d)a | Responders vs nonresponders | 18 vs 21 | 75 ± 3 vs 79 ± 2 | 3.5 ± 1.4 vs 3.9 ± 1.4 | 15 vs 15 | 11; 28 | 41 |
Conversion factor for serum creatinine in mg/dL to μmol/L, X 88.4.
Abbreviations: HRS = hepatorenal syndrome; MAP = mean arterial pressure; MELD = model for end-stage liver disease; Alb = albumin; GPS, gelatin polysuccinate; NA = not available; M, male; SCr, serum creatinine; FFP, fresh-frozen plasma; DE, Germany; ES, Spain; RU, Russia; US, United States; FR, France; BE, Belgium; CA, Canada; MX, Mexico; IT, Italy; IN, India.
z
Age is expressed as mean ± standard error or mean [range].
y
Class C corresponds to Child-Pugh scores of 10-15 points.
b
Values expressed as mean ± standard error or median [range].
a
Dose given as: (1st day; thereafter)
c
Values represent median or mean duration of therapy.
d
Values reported only for terlipressin + Alb arm, not provided for Alb-only arm.