{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:42:16Z","timestamp":1792194136820,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T00:00:00Z","timestamp":1661126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous studies suggested increased mortality in patients with hepatorenal syndrome type 1 (HRS1) and advanced acute\u2010on\u2010chronic liver failure (ACLF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To assess mortality and respiratory failure (RF) in patients with HRS1 and ACLF treated with terlipressin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In the CONFIRM study, we randomised 299 patients with HRS1 2:1 to terlipressin or placebo, both with albumin. At enrolment, all patients were assessed for organ failure (OF) using a validated ACLF grading system. Post hoc analyses assessed the effects of terlipressin vs. placebo on the incidence of RF and 90\u2010day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence of RF with terlipressin (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u2009200) was 9.4% in patients with grades 1\u20132 ACLF, and 30% with grade 3 ACLF (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.0002); no such difference was observed in placebo\u2010treated patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u200999) (6.2% grades 1\u20132 vs. 0% grade 3 ACLF,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u20090.05). RF incidence between terlipressin and placebo in patients with grade 3 ACLF was significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.01). Baseline predictors of RF with terlipressin were INR (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.011), mean arterial pressure (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.037), and SpO\n                      <jats:sub>2<\/jats:sub>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.014). Prior albumin as a continuous variable was not a predictor of RF. 90\u2010day survival between terlipressin and placebo arms was similar for grades 1\u20132 ACLF (55.5% and 56.6%, respectively), but lower for grade 3 ACLF (27.55% vs. 50.0%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.122), mainly related to RF.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Terlipressin should be used with caution in patients with HRS1 and grade 3 ACLF. Patients with hypoxaemia are at increased risk of RF and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.17195","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T21:58:38Z","timestamp":1661205518000},"page":"1284-1293","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":75,"title":["Terlipressin use and respiratory failure in patients with hepatorenal syndrome type 1 and severe\n                    <scp>acute\u2010on\u2010chronic<\/scp>\n                    liver failure"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9263-8869","authenticated-orcid":false,"given":"Florence","family":"Wong","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Toronto General Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7677-6628","authenticated-orcid":false,"given":"Stephen Chris","family":"Pappas","sequence":"additional","affiliation":[{"name":"Orphan Therapeutics LLC  Longboat Key Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4898-7778","authenticated-orcid":false,"given":"K. Rajender","family":"Reddy","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Vargas","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\/Hepatology Mayo Clinic  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2110-3503","authenticated-orcid":false,"given":"Michael P.","family":"Curry","sequence":"additional","affiliation":[{"name":"Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8682-5748","authenticated-orcid":false,"given":"Arun","family":"Sanyal","sequence":"additional","affiliation":[{"name":"Department of Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khurram","family":"Jamil","sequence":"additional","affiliation":[{"name":"Mallinckrodt Pharmaceuticals  Bedminster New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"1310","article-title":"Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis","volume":"56","author":"Salerno F","year":"2007","journal-title":"Gut"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-018-0022-7"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m2687"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-020-00292-0"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(16)30157-1"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2008290"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30056"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.02.042"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000000150"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2015.11.019"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31012"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1176350951"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.01.035"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.02.024"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.02.014"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.026"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005162.pub3"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003319711411704"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00328.2019"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e32833a4822"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28740"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells9122632"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2020.100176"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000000052"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.04.020"}],"updated-by":[{"DOI":"10.1111\/apt.18120","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000}}],"container-title":["Alimentary Pharmacology &amp; 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