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Review
. 2025 Jan 23:87551225241311444.
doi: 10.1177/87551225241311444. Online ahead of print.

Comparison of 12- to 24-Hour Versus 72-Hour Intravenous Terlipressin in Patients With Acute Esophageal Variceal Bleeding: A Systematic Review and Meta-analysis

Mohammad Al Hayek  1 , Bisher Sawaf  2 , Shahem Abbarh  3 , Sudheer Dhoop  2 , Abdallah Khashan  4 , Ahmed Hassan  5 , Alhasan Saleh Alzubi  6 , Abdelrahman F Abdelwahed  7 , Abdussalam I A Alzein  8 , Mohamedhen Vall Nounou  9 , Yaseen Alastal  10 , Muhammed Elhadi  11
Affiliations
Review

Comparison of 12- to 24-Hour Versus 72-Hour Intravenous Terlipressin in Patients With Acute Esophageal Variceal Bleeding: A Systematic Review and Meta-analysis

Mohammad Al Hayek et al. J Pharm Technol. .

Abstract

Objective: To compare the efficacy and safety of 12-24 hours versus 72 hours of intravenous terlipressin therapy in patients with acute esophageal variceal bleeding (AVB). Data sources: A systematic search was conducted using PubMed, Scopus, Cochrane Library, Google Scholar, Web of Science, VHL, and ClinicalTrials.gov for studies published up to February 24, 2024. The search terms included "terlipressin," "variceal bleeding," "short-course," and "72-hour treatment." Study selection and data extraction: Randomized controlled trials (RCTs) comparing 12 to 24 hours with 72 hours of terlipressin therapy in patients with AVB were included. Studies not meeting these criteria or focusing on unrelated outcomes were excluded. Two authors conducted data extraction and bias assessment independently, with discrepancies resolved by a third reviewer. Baseline characteristics and outcomes (rebleeding and mortality within 5 days) were recorded. Results: Four RCTs with 469 patients were included in the analysis. There were no significant differences observed in 5-day rebleeding rates (OR = 0.943; 95% CI [0.384, 2.317]; P = 0.898) or mortality rates (OR = 0.386; 95% CI [0.066, 2.260]; P = 0.291) between terlipressin treatment durations of 12 to 24 hours and 72 hours within the first 5 days posttreatment. In addition, no heterogeneity was found in both variables (P > 0.1). Conclusion: This meta-analysis indicates that there is no significant difference in rebleeding rates or mortality between 12 to 24 hours and 72 hours of terlipressin therapy for AVB within 5 days posttreatment. Shorter treatment durations may offer advantages in terms of resource utilization and adverse event risk but require further validation through studies involving larger patient populations.

Keywords: bleeding; esophageal variceal; meta-analysis; terlipressin; vasopressors.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram illustrates the process of study screening and selection.
Figure 2.
Figure 2.
Risk of bias assessment of included studies using ROB2 tool.
Figure 3.
Figure 3.
(a) Forest plot of 5-day rebleeding odds ratio. (b) Forest plot of 5-day mortality odds ratio.
See this image and copyright information in PMC

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References

    1. Shaheen AA, Nguyen HH, Congly SE, Kaplan GG, Swain MG. Nationwide estimates and risk factors of hospital readmission in patients with cirrhosis in the United States. Liver Int. 2019;39(5):878-884. doi:10.1111/liv.14054 - DOI - PubMed
    1. Grace ND. Diagnosis and treatment of gastrointestinal bleeding secondary to portal hypertension. American College of Gastroenterology Practice Parameters Committee. Am J Gastroenterol. 1997;92(7):1081-1091. - PubMed
    1. D’Amico G, De Franchis R; Cooperative Study Group. Upper digestive bleeding in cirrhosis. Post-therapeutic outcome and prognostic indicators. Hepatology. 2003;38(3):599-612. doi:10.1053/jhep.2003.50385 - DOI - PubMed
    1. Chalasani N, Kahi C, Francois F, et al. Improved patient survival after acute variceal bleeding: a multicenter, cohort study. Am J Gastroenterol. 2003;98(3):653-659. doi:10.1111/j.1572-0241.2003.07294.x - DOI - PubMed
    1. Sohal A, Chaudhry H, Dhaliwal A, et al. Gender differences in esophageal variceal bleeding in the United States. Ann Med. 2022;54(1):2115-2122. doi:10.1080/07853890.2022.2104920 - DOI - PMC - PubMed

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