Variceal Bleeding

Hemorrhage from esophageal or gastric varices, which are dilated blood vessels that develop due to portal hypertension in patients with cirrhosis. A life-threatening complication requiring urgent treatment with mortality rates up to 20% per episode.

Quick Answer

What it is

Hemorrhage from esophageal or gastric varices, which are dilated blood vessels that develop due to portal hypertension in patients with cirrhosis. A life-threatening complication requiring urgent treatment with mortality rates up to 20% per episode.

Key findings

  • Grade A: Mortality Reduction (Variceal Bleeding) (Terlipressin (Terlivaz))
  • Grade A: Bleeding Control (Variceal) (Terlipressin (Terlivaz))

Safety

  • 34% relative risk reduction.
ℹ️ Quick Facts

Quick Facts: Variceal Bleeding

  • Supplements Studied:1
1 supps · 2 outcomes

Detailed Outcomes

A
Mortality Reduction (Variceal Bleeding)
Cochrane meta-analysis (7 RCTs, 443 patients): Terlipressin reduced all-cause mortality vs placebo (RR 0.66, 95% CI 0.49-0.88). 34% relative risk reduction. The only vasoactive agent proven to reduce mortality in acute variceal hemorrhage.
large↓Improves
A
Bleeding Control (Variceal)
2018 meta-analysis (30 RCTs, 3344 patients): Terlipressin significantly improved bleeding control within 48h vs no vasoactive drug (OR 2.94, P=0.0008). Reduced need for emergency procedures (RR 0.72 vs placebo).
large↑Improves

Research Citations (37)

Multisystem hemodynamic effects of terlipressin in cirrhosis: A scoping review.
(2025)
PMID: 39955856
Terlipressin for the treatment of hepatorenal syndrome: a meta-analysis of randomized controlled trials.
(2025)
PMID: 40207491
Terlipressin Administration Strategies in Hepatorenal Syndrome-Acute Kidney Injury: A Narrative Review of Continuous Infusion and Intermittent Bolus Approaches.
(2025)
PMID: 41314419
Terlipressin use in HRS-AKI and respiratory failure.
(2024)
PMID: 39073583
Safety and efficacy of continuous terlipressin infusion in HRS-AKI in a transplant population.
(2024)
PMID: 38771635
Incidence and type of adverse events in patients with cirrhosis receiving terlipressin: A systematic review and meta-analysis.
(2024)
PMID: 39298544
Comparative efficacy of terlipressin and norepinephrine for treatment of hepatorenal syndrome-acute kidney injury: A systematic review and meta-analysis.
(2024)
PMID: 38285703
Early treatment with terlipressin in patients with hepatorenal syndrome yields improved clinical outcomes in North American studies
(2023)
PMID: 36633470
Terlipressin and the Treatment of Hepatorenal Syndrome: How the CONFIRM Trial Moves the Story Forward
(2022)
PMID: 34606933
Respiratory events with terlipressin and albumin in hepatorenal syndrome: A review and clinical guidance.
(2022)
PMID: 35838488

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