Lack of effect of pentoxifylline on portal pressure and hepatic haemodynamics in cirrhosis

Feu, F; García-Pagán, JC; Arbol, L.Ruiz del; Cirera, Isabel; Pizcueta, Pilar; Bosch, Jan; Rodés, Juan

doi:10.1016/0168-8278(90)91679-q

Cited by 3 publications

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“… 54 Three studies have investigated the effect of the acute, but not chronic, administration of oxpentifylline (pentoxifylline) in patients with cirrhosis. One study reported a 13.6% fall in the hepatic venous pressure gradient without significant effects on splanchnic or systemic haemodynamics; 33 another did not 32 . A third study demonstrated a 36% fall in intra‐variceal pressure in cirrhotics with a mainly non‐alcoholic aetiology 31 .…”

Section: Discussionmentioning

confidence: 99%

“…Oxpentifylline (pentoxifylline) reduces noradrenaline (norepinephrine)‐induced intra‐hepatic vasoconstriction in the isolated perfused rat liver 28 and, in portal hypertensive rats, acute administration of oxpentifylline (pentoxifylline) significantly reduces portal pressure 29 ,. 30 Portal pressure studies in humans have produced conflicting results 31–33 . More recently, oxpentifylline (pentoxifylline) has been shown to improve the short‐term survival in patients with severe alcoholic hepatitis 34 …”

Section: Introductionmentioning

confidence: 99%

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A pilot study to investigate the use of oxpentifylline (pentoxifylline) and thalidomide in portal hypertension secondary to alcoholic cirrhosis

Austin

Mahida

Clarke³

et al. 2003

Aliment Pharmacol Ther

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SUMMARYBackground: Tumour necrosis factor-a is thought to be important in the pathogenesis of portal hypertension. Oxpentifylline (pentoxifylline) and thalidomide inhibit endotoxin-induced tumour necrosis factor-a production in vitro. Aims: To assess the toxicity of oxpentifylline (pentoxifylline) and thalidomide in cirrhosis and their effect on the hepatic venous pressure gradient and tumour necrosis factor-a production. Methods:In an open-label pilot study, 20 abstinent patients with stable alcoholic cirrhosis and oesophageal varices were recruited; 12 patients completed haemodynamic measurements before and after treatment with oxpentifylline (pentoxifylline) 1800 mg (n ¼ 6) or thalidomide 200 mg (n ¼ 6) daily for 2 weeks. Tumour necrosis factor-a production was assessed in ex vivo monocyte cultures stimulated with endotoxin.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A pilot study to investigate the use of oxpentifylline (pentoxifylline) and thalidomide in portal hypertension secondary to alcoholic cirrhosis

Austin

Mahida

Clarke³

et al. 2003

Aliment Pharmacol Ther

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Modulation of intravariceal pressure with pentoxifylline: a possible new approach in the treatment of portal hypertension

Eleftheriadis

Kotzampassi

Koufogiannis

1998

American Journal of Gastroenterology

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Efecto de la pentoxifilina en la supervivencia, la función cardiaca y en la hemodinámica portal y sistémica de la cirrosis alcohólica avanzada: a randomized double-blind placebo-controlled trial

Fernández-Rodrı́guez

Lledó

López-Serrano

et al. 2008

Rev. esp. enferm. dig.

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INTRODUCCIÓNLos pacientes con cirrosis descompensada presentan cambios hemodinámicos entre los que se incluyen una disminución de las resistencias vasculares periféricas y Efecto de la pentoxifilina en la supervivencia, la función cardiaca y en la hemodinámica portal y sistémica de la cirrosis alcohólica avanzada RESUMENObjetivo: valorar el efecto de la pentoxifilina (un potente inhibidor del factor de necrosis tumoral alfa) en la supervivencia, en la hemodinámica sistémica y portal y en la función cardiaca en la cirrosis alcohólica avanzada.Diseño: estudio aleatorizado, doble-ciego, controlado con placebo.Contexto: estudio unicéntrico utilizando grupos de pacientes en paralelo para comparar pentoxifilina y placebo.Pacientes: se incluyeron 24 pacientes con cirrosis alcohólica (8 en estadio B de Child-Pugh y 16 en estadio C de Child-Pugh).Intervención: los pacientes fueron aleatorizados a recibir pentoxifilina (400 mg, 3 veces al día, n = 12) o placebo (n = 12) durante 4 semanas.Determinaciones: el objetivo principal fue la supervivencia a corto/largo plazo. Los objetivos secundarios fueron observar beneficios hemodinámicos (mejoría en la función cardiaca y/o en el índice de resistencias vasculares sistémicas o disminución de la presión portal).Resultados: la presión portal y la función cardiaca no se modificaron y no hubo diferencias en la supervivencia a corto y largo plazo entre los grupos tratados y placebo. Los índices de resistencia vascular sistémica y cardiaco cambiaron en el grupo de pentoxifilina (de 1.721 ± 567 a 2.082 ± 622 Din.seg 1 cm -5 m -2 y de 4,17 ± 1,4 a 3,4 ± 0,9 lm -2 , p = 0,05).Conclusiones: aunque la pentoxifilina parece producir algún beneficio hemodinámico a corto plazo en pacientes con cirrosis alcohólica avanzada, no tiene efecto sobre la tasa de supervivencia, la función cardiaca ni sobre la presión portal en estos pacientes. Palabras clave:Inhibición del TNF-α. Hemodinámica. Miocardiopatía cirrótica. Cirrosis alcohólica. ABSTRACTObjective: to assess the effect of pentoxiphylline (a potent inhibitor of tumor necrosis factor alpha) on survival, on systemic and portal hemodynamics, and on cardiac function in patients with alcoholic cirrhosis.Design: a randomized double-blind placebo-controlled trial. Setting: a single center using parallel groups of patients to compare pentoxiphylline with placebo.Patients: we recruited 24 patients with alcoholic cirrhosis (8 Child-Pugh B and 16 Child-Pugh C).Interventions: patients were randomly assigned to receive pentoxiphylline (400 mg tid; n = 12) or placebo (n = 12) over a 4-week period.Outcome measures: the primary outcome was to extend short-term and long-term survival. Secondary outcomes included hemodynamic benefits (improvement in cardiac function and/or systemic vascular resistance index, or decrease in portal pressure).Results: portal pressure and cardiac function remained unchanged and there were no significant differences in short-term or long-term survival between treatment and placebo groups. The group on pentoxiphylline increased sys...

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Lack of effect of pentoxifylline on portal pressure and hepatic haemodynamics in cirrhosis

Cited by 3 publications

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A pilot study to investigate the use of oxpentifylline (pentoxifylline) and thalidomide in portal hypertension secondary to alcoholic cirrhosis

A pilot study to investigate the use of oxpentifylline (pentoxifylline) and thalidomide in portal hypertension secondary to alcoholic cirrhosis

Modulation of intravariceal pressure with pentoxifylline: a possible new approach in the treatment of portal hypertension

Efecto de la pentoxifilina en la supervivencia, la función cardiaca y en la hemodinámica portal y sistémica de la cirrosis alcohólica avanzada: a randomized double-blind placebo-controlled trial

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