Effectiveness and Safety Evaluation of Terlipressin in the Treatment of Dynamic Intestinal Obstruction in End-Stage Liver Disease

Abstract

Abstract Dynamic intestinal obstruction is a common complication in end-stage liver disease (ESLD), our aim is to assess the effectiveness and safety of low-dose terlipressin for treating dynamic intestinal obstruction in ESLD. The study was divided into two phases, in the exploratory phase, low-dose terlipressin was administered to treat patients with dynamic intestinal obstruction in an attempt to explore its effectiveness. In the clinical research phase, patients with intestinal obstruction were categorized into terlipressin treatment group (low-dose terlipressin was added to the conventional treatment) and conventional treatment group (1:3) using permuted-block randomization. The remission of intestinal obstruction, time to symptom remission, and differences in adverse reactions were compared between the two groups. In the exploratory phase, 26 patients were exposed to low-dose terlipressin, 12 were cured, 11 were moderately effective, and 3 were ineffective. The mean time to abdominal bloating remission was 2 days, and the time to anal flatus and feces passage was 1 day. In the clinical research phase, 131 patients with intestinal obstruction were enrolled，the mean time to abdominal pain and bloating remission, as well as anal flatus and feces passage in the terlipressin treatment group (32/131) was demonstrably shorter compared to the conventional treatment group (98/131) (P<0.001), and the remission rate was higher than that in the conventional treatment group (P<0.05). The incidence of adverse events was similar. Low-dose terlipressin treatment could considerably increase intestinal obstruction remission in ESLD patients with dynamic intestinal obstruction, and have good safety.