Terlipressin

(Terlivaz®)

Terlivaz®

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Drug updated on 4/18/2024

Dosage FormInjection (intravenous; 0.85 mg/vial)
Drug ClassVasopressin receptor agonists
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated to improve kidney function in adults with hepatorenal syndrome with rapid reduction in kidney function.

Summary
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  • Terlipressin (Terlivaz) is indicated to improve kidney function in adults with hepatorenal syndrome, showing a promising profile in managing this condition and offering a competitive alternative to other vasoconstrictors like noradrenaline.
  • Nine studies primarily focused on adult populations suffering from hepatorenal syndrome or related acute kidney injury within the cirrhosis spectrum.
  • Comparative studies between terlipressin and noradrenaline showed minimal differences in effectiveness regarding hepatorenal syndrome reversal and mortality rates. However, adverse events varied: abdominal pain and diarrhea for terlipressin versus cardiovascular issues for noradrenaline.
  • The combination of terlipressin and albumin has been advocated due to its effectiveness in reversing renal failure. In liver transplantation settings, it potentially reduces acute kidney injury incidence due to its hemodynamic benefits but the clinical relevance was questioned concerning post-transplant outcomes.
  • Compared with placebo, terlipressin increases hepatorenal syndrome reversal rates, potentially reduces mortality but may increase the risk of serious adverse events, necessitating a cautious evaluation of the risk-benefit ratio.
  • Research exploring uses beyond hepatorenal syndrome indicates potential benefits of using Terlivaz (terlipressin) in improving hemodynamics and renal function associated with conditions such as ascites or circulatory dysfunction post-paracentesis; however, subgroup considerations are generally lacking in detail, signifying an area requiring further research.

Product Monograph / Prescribing Information

Document TitleYearSource
Terlivaz (terlipressin) prescribing information. 2022Mallinckrodt Hospital Products Inc., Bedminster, NJ

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Efficacy and safety of terlipressin and albumin vs. noradrenaline and albumin in adult patients with hepatorenal syndrome: a systematic review and meta-analysis.2024Annals of Hepatology
Comparative efficacy of terlipressin and norepinephrine for treatment of hepatorenal syndrome-acute kidney injury: a systematic review and meta-analysis.2024PLoS
A comprehensive systematic review of the latest management strategies for hepatorenal syndrome: a complicated syndrome to tackle. 2023Cureus
A systematic review of the emerging treatment for hepatorenal syndrome with a principal focus on terlipressin: a recent FDA-approved drug. 2023Cureus
Prophylactic perioperative terlipressin therapy for preventing acute kidney injury in living donor liver transplant recipients: a systematic review and meta-analysis.2022Journal of Clinical and Experimental Hepatology
The comparative effectiveness of vasoactive treatments for hepatorenal syndrome: a systematic review and network meta-analysis.2022Critical Care Medicine
Limited progress in hepatorenal syndrome (HRS) reversal and survival 2002-2018: a systematic review and meta-analysis.2020Digestive Diseases and Sciences
Role of terlipressin in cirrhotic patients with ascites and without hepatorenal syndrome: a systematic review of current evidence.2020Canadian Journal of Gastroenterology & Hepatology
Treatment for hepatorenal syndrome in people with decompensated liver cirrhosis: a network meta-analysis.2019Cochrane Database of Systematic Reviews