1043 Pentoxifylline (Ptx) Reduces the Risk of Complications in Patients With Advanced Cirrhosis. Analysis of the Results of a Pivotal Phase 3 Trial

Lebrec, Didier; Thabut, D.; Oberti, Frédéric; Perarnau, Jean–Marc; Condat, Bertrand; Barraud, Hélène; Saliba, F.; Carbonell, N.; Renard, P; Ramond, MJ; Moreau, R.; Poynard, Thierry

doi:10.1016/s0168-8278(09)61045-x

Cited by 4 publications

(3 citation statements)

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“…Interestingly, preliminary results of a large double-blind RCT show that oral pentoxifylline administration (1200 mg/day) significantly decreases the risk of bacterial infection in patients with advanced cirrhosis. 82 Catheter-Related Infections. These infections are common in critically ill patients with cirrhosis.…”

Section: Prevention Of Sepsis In Cirrhosismentioning

confidence: 99%

Severe sepsis in cirrhosis

et al. 2009

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Sepsis is physiologically viewed as a proinflammatory and procoagulant response to invading pathogens. There are three recognized stages in the inflammatory response with progressively increased risk of end-organ failure and death: sepsis, severe sepsis, and septic shock. Patients with cirrhosis are prone to develop sepsis, sepsis-induced organ failure, and death. There is evidence that in cirrhosis, sepsis is accompanied by a markedly imbalanced cytokine response ("cytokine storm"), which converts responses that are normally beneficial for fighting infections into excessive, damaging inflammation. Molecular mechanisms for this excessive proinflammatory response are poorly understood. In patients with cirrhosis and severe sepsis, high production of proinflammatory cytokines seems to play a role in the worsening of liver function and the development of organ/system failures such as shock, renal failure, acute lung injury or acute respiratory distress syndrome, coagulopathy, or hepatic encephalopathy. In addition, these patients may have sepsis-induced hyperglycemia, defective arginine-vasopressin secretion, adrenal insufficiency, or compartmental syndrome. In patients with cirrhosis and spontaneous bacterial peritonitis (SBP), early use of antibiotics and intravenous albumin administration decreases the risk for developing renal failure and improves survival. There are no randomized studies that have been specifically performed in patients with cirrhosis and severe sepsis to evaluate treatments that have been shown to improve outcome in patients without cirrhosis who have severe sepsis or septic shock. These treatments include recombinant human activated C protein and protectiveventilation strategy for respiratory failure. Other treatments should be evaluated in the cirrhotic population with severe sepsis including the early use of antibiotics in "non-SBP" infections, vasopressor therapy, hydrocortisone, renal-replacement therapy and liver support systems, and selective decontamination of the digestive tract or oropharynx.

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Section: Prevention Of Sepsis In Cirrhosismentioning

confidence: 99%

Severe sepsis in cirrhosis

et al. 2009

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“…This is why alternative approaches are needed. Interestingly, preliminary results of a large double‐blind RCT show that oral pentoxifylline administration (1200 mg/day) significantly decreases the risk of bacterial infection in patients with advanced cirrhosis 82…”

Section: Prevention Of Sepsis In Cirrhosismentioning

confidence: 99%

Mediation of the proinflammatory cytokine response in rheumatoid arthritis and spondylarthritis by interactions between fibroblast‐like synoviocytes and natural killer cells

Chan¹,

Filer²,

Parsonage³

et al. 2008

Arthritis & Rheumatism

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Objective. Fibroblast-like synoviocytes (FLS) are potentially directly involved in the propagation of inflammation. We have previously shown evidence of an expanded activated population of natural killer (NK) cells in spondylarthritis (SpA) patients. In the present study, we sought to determine whether the interaction between NK cells and FLS from SpA patients results in a proinflammatory response.Methods. Autologous NK cells and FLS were obtained from 6 patients with SpA, 4 patients with rheumatoid arthritis (RA), and 8 patients with osteoarthritis (OA). Physical interactions between NK cells and FLS were studied by time-lapse phase-contrast microscopy. Fluorescence-activated cell sorting was used to study the activation, proliferation, and survival of NK cells in contact with FLS. Cytokine and stromal factor production were measured by a multiple cytokine bead assay.Results. NK cells both adhered to and migrated beneath the FLS monolayer (pseudoemperipolesis).

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“…Encontramos dos revisiones sistemáticas [1], [2] que incluyen 10 estudios randomizados reportados en 13 artículos [3], [4], [5],[6], [7], [8], [9], [10], [11], [12], [13], [14], [15].…”

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Is pentoxifylline effective in alcoholic hepatitis?

Rada¹,

Arteaga²

2014

Medwave

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Pentoxifyllin probably reduces mortality when compared with placebo. Pentoxifyllin could be less effective than steroid therapy for reducing mortality. Addition of pentoxifyllin to steroid therapy does not reduce mortality. Most practice guidelines have not taken into account an important portion of the existing evidence, even though their recommendations are in accordance with the present review.

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1043 Pentoxifylline (Ptx) Reduces the Risk of Complications in Patients With Advanced Cirrhosis. Analysis of the Results of a Pivotal Phase 3 Trial

Cited by 4 publications

References 0 publications

Severe sepsis in cirrhosis

Severe sepsis in cirrhosis

Mediation of the proinflammatory cytokine response in rheumatoid arthritis and spondylarthritis by interactions between fibroblast‐like synoviocytes and natural killer cells

Is pentoxifylline effective in alcoholic hepatitis?

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