Continuous vs. intermittent terlipressin infusion for portal hypertension: a systematic review and meta-analysis.
Annals of medicine and surgery (2012)
BACKGROUND: Portal hypertension, a major complication of chronic liver disease, often leads to life-threatening variceal bleeding, managed effectively with vasoactive drugs like terlipressin. However, the most optimal method of terlipressin administration, continuous versus intermittent infusion, remains a subject of debate, necessitating this systematic review and meta-analysis for evidence-based decision-making in managing this critical condition.
METHODS: This systematic review and meta-analysis adhered to the PRISMA standards and explored multiple databases until 6 April 2023, such as MEDLINE through PubMed, Scopus, Web of Science, and CENTRAL. Independent reviewers selected randomized controlled trials (RCTs) that met specific inclusion criteria. After assessing study quality and extracting necessary data, statistical analysis was performed using Review Manager (RevMan), with results presented as risk ratios (RR) or mean differences.
RESULTS: Five RCTs (
CONCLUSION: This study provides robust evidence suggesting that continuous terlipressin infusion may be superior to intermittent infusions in reducing the risk of rebleeding, treatment failure, and adverse effects in patients with portal hypertension. However, further large-scale, high-quality RCTs are required to confirm these findings and to investigate the potential benefits of continuous terlipressin infusion on mortality and hospital stays.
Hassan M, Merza N, Nawras Y, Bahbah EI, Al-Hillan A, Ahmed Z, et al Continuous vs. intermittent terlipressin infusion for portal hypertension: a systematic review and meta-analysis. Ann Med Surg (Lond). 2023 Sep 5;85(10):5001-5010. doi: 10.1097/MS9.0000000000001261. PMID: 37811089.