{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T19:03:25Z","timestamp":1775243005697,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2006,8,31]],"date-time":"2006-08-31T00:00:00Z","timestamp":1156982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2006,9]]},"abstract":"<jats:sec><jats:title>Summary<\/jats:title><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The hepatorenal syndrome is a severe and well\u2010known complication of end\u2010stage liver disease, but its management is controversial. Recent reports have shown the efficacy of terlipressin therapy, a vasopressin analogue, in hepatorenal syndrome patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the efficacy and safety of terlipressin in the treatment of hepatorenal syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a systematic review of the literature with a meta\u2010analysis of clinical trials. The primary outcome (as a measure of efficacy) was the rate of responder patients (i.e. patients who had hepatorenal syndrome reversal after terlipressin therapy). The secondary outcomes were the rate of responders who had hepatorenal syndrome recurrence after terlipressin withdrawal, and the drop\u2010out rate (as a measure of tolerability). We used the random effects model of DerSimonian and Laird with heterogeneity and sensitivity analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 10 clinical trials (154 unique patients); two (20.0%) were randomized, controlled trials. The pooled rate of patients who reversed hepatorenal syndrome after terlipressin therapy was 0.52 (95% CI, 0.42; 0.61), <jats:italic>P<\/jats:italic>\u2003=\u20030.0001; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2003=\u200324.6%. The pooled frequency of responder patients who showed hepatorenal syndrome recurrence after terlipressin withdrawal was 0.55 (95% CI, 0.40; 0.69), <jats:italic>P<\/jats:italic>\u2003=\u20030.00001; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2003=\u200344.3%. The pooled rate of patients who showed side\u2010effects to terlipressin therapy was 0.29 (95% CI, 0.17; 0.42), <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.0001, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2003=\u200366.6%. The drop\u2010out rate was 0%. The pooled OR for mortality rate in hepatorenal syndrome patients who were not responders to terlipressin vs. responder patients was 5.746 (95% CI, 1.5; 21.9). We did not find any predictive factor of response to terlipressin therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This meta\u2010analysis shows efficacy and safety of terlipressin in the treatment of hepatorenal syndrome. However, a significant number of responder patients relapsed after terlipressin withdrawal. Further studies are in progress to address the link between terlipressin and survival in hepatorenal syndrome patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2036.2006.03086.x","type":"journal-article","created":{"date-parts":[[2006,8,31]],"date-time":"2006-08-31T09:39:32Z","timestamp":1157017172000},"page":"935-944","source":"Crossref","is-referenced-by-count":91,"title":["Meta\u2010analysis: terlipressin therapy for the hepatorenal syndrome"],"prefix":"10.1111","volume":"24","author":[{"given":"F.","family":"FABRIZI","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"DIXIT","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"MARTIN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,8,31]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14903-3"},{"key":"e_1_2_6_3_2","first-page":"148","article-title":"Impact of pretransplant renal function on survival after liver transplantation","volume":"93","author":"Gonwa AT","year":"1995","journal-title":"Transplantation"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.33160"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199712270-00024"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510270107"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510300430"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02088218"},{"key":"e_1_2_6_9_2","first-page":"2113","article-title":"Terlipressin may influence the outcome of hepatorenal syndrome complicating alcoholic cirrhosis","volume":"92","author":"Cervoni JP","year":"1997","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_6_10_2","first-page":"268","article-title":"Treatment with terlipressin as a bridge to liver transplantation in a patient with hepatorenal syndrome","volume":"61","author":"Le Moine O","year":"1998","journal-title":"Acta Gastroenterol Belg"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(00)80158-0"},{"key":"e_1_2_6_12_2","volume-title":"Fachinformation: Glycylpressin R, Terlipressin Acetate","year":"1996"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(85)90103-5"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510230122"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1091"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(98)80151-7"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2000.03214.x"},{"key":"e_1_2_6_20_2","first-page":"15","article-title":"Long\u2010term terlipressin administration improves renal function in cirrhotic patients with type 1 hepatorenal syndrome: a pilot study","author":"Mulkay JP","year":"2001","journal-title":"Acta Gastroenterol Belg"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200212000-00013"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200202000-00009"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.35819"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1746.2002.02816.x"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1746.2003.02934.x"},{"key":"e_1_2_6_26_2","first-page":"ccciii","article-title":"Terlipressin and albumin combination treatment in hepatorenal syndrome","volume":"50","author":"Danalioglu A","year":"2003","journal-title":"Hepato-Gastroenterology"},{"key":"e_1_2_6_27_2","first-page":"78","article-title":"Terlipressin and gelafundin: safe therapy of hepatorenal syndrome","volume":"9","author":"Saner FH","year":"2004","journal-title":"Eur J Med Res"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.32364"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21094"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20044"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2001.22172"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(93)90031-7"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2003.09.019"},{"key":"e_1_2_6_34_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_6_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.00271.x"}],"container-title":["Alimentary Pharmacology &amp; 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