Year 2008 / Volume 100 / Number 8
Original
Effect of pentoxiphylline on survival, cardiac function and both portal and systemic hemodynamics in advanced alcoholic cirrhosis: a randomized double-blind placebo-controlled trial

pp. 481-489

Fernández-Rodríguez, C. M. / Lledó, J. L. / López-Serrano, P. / Gutiérrez, M. L. / Alonso, S. / Pérez-Fernández, M. T. / Fernández Gil, M. / Pazos, R. / Tolon, R. / Hernández, T. / Sanz, P.

Abstract
Objective: 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 systemic vascular resistance and decreased cardiac indices (from 1,721 ± 567 to 2,082 ± 622 dyn.sec-1 cm-5 m-2 and from 4.17 ± 1.4 to 3.4 ± 0.9 l.m-2, p = 0.05).

Conclusions: although pentoxiphylline seems to provide some short-term hemodynamic benefits in patients with advanced alcoholic cirrhosis, this drug has no effect on survival or portal pressure in these patients.
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Fernández-Rodríguez, C. M. / Lledó, J. L. / López-Serrano, P. / Gutiérrez, M. L. / Alonso, S. / Pérez-Fernández, M. T. / Fernández Gil, M. / Pazos, R. / Tolon, R. / Hernández, T. / Sanz, P.. Effect of pentoxiphylline on survival, cardiac function and both portal and systemic hemodynamics in advanced alcoholic cirrhosis: a randomized double-blind placebo-controlled trial. 481-489


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