Targeted Albumin Therapy Does Not Improve Short-Term Outcome in Hyponatremic Patients Hospitalized With Complications of Cirrhosis: Data From the ATTIRE Trial.
Journal
The American journal of gastroenterology
ISSN: 1572-0241
Titre abrégé: Am J Gastroenterol
Pays: United States
ID NLM: 0421030
Informations de publication
Date de publication:
01 11 2021
01 11 2021
Historique:
received:
27
05
2021
accepted:
19
07
2021
pubmed:
15
9
2021
medline:
25
11
2021
entrez:
14
9
2021
Statut:
ppublish
Résumé
Patients with decompensated cirrhosis and hyponatremia have a poor prognosis. We investigated Albumin to Prevent Infection in Chronic Liver Failure trial data to determine whether targeted albumin infusions improved outcome in patients with hyponatremia at baseline. We examined the interaction between targeted albumin and standard care for the composite primary end point, stratifying by baseline sodium ≥ and <130 mmol/L. Randomization to albumin was associated with a significant increase in sodium; however, there was no interaction between sodium category and treatment for the trial primary end point. Targeted intravenous albumin infusions increased serum sodium level in hospitalized hyponatremic patients with cirrhosis, but this did not improve outcome.
Identifiants
pubmed: 34520431
doi: 10.14309/ajg.0000000000001488
pii: 00000434-202111000-00025
doi:
Substances chimiques
Albumins
0
Banques de données
EudraCT
['2014-002300-24']
ISRCTN
['ISRCTN14174793']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2292-2295Subventions
Organisme : Department of Health
ID : HICF-R8-439
Pays : United Kingdom
Organisme : Wellcome Trust
ID : WT102568
Pays : United Kingdom
Informations de copyright
Copyright © 2021 by The American College of Gastroenterology.
Références
Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med 2008;359:1018–26.
Biggins SW, Tandon P, O'Leary JG, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology 2006;130:1652–60.
Lizaola B, Bonder A, Tapper EB, et al. The changing role of sodium management in cirrhosis. Curr Treat Options Gastroenterol 2016;14:274–84.
Dahl E, Gluud LL, Kimer N, et al. Meta-analysis: The safety and efficacy of vaptans (tolvaptan, satavaptan and lixivaptan) in cirrhosis with ascites or hyponatraemia. Aliment Pharmacol Ther 2012;36:619–26.
Bajaj J, Tandon P, OʼLeary JG, et al. The impact of albumin use on resolution of hyponatremia in hospitalized patients with cirrhosis. Am J Gastroenterol 2018;113(9):1339.
China L, Freemantle N, Forrest E, et al. A randomized trial of albumin infusions in hospitalized patients with cirrhosis. N Engl J Med 2021;384:808–17.
China L, Skene SS, Bennett K, et al. Attire: Albumin to prevenT infection in chronic liveR failurE: Study protocol for an interventional randomised controlled trial. BMJ Open 2018;8(10):e023754.
Ginès P, Guevara M. Hyponatremia in cirrhosis: Pathogenesis, clinical significance, and management. Hepatology 2008;48(3):1002–10.