Resumo

FERNANDEZ-RODRIGUEZ, C. M. et al. Effect of pentoxiphylline on survival, cardiac function, and portal and systemic hemodynamics in advanced alcoholic cirrhosis. Rev. esp. enferm. dig. [online]. 2008, vol.100, n.8, pp.481-489. ISSN 1130-0108.

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 aemodynamic benefits in patients with advanced alcoholic cirrhosis, this drug has no effect on survival or portal pressure in these patients.

Palavras-chave : TNF-ainhibition; Haemodynamics; Cirrhotic cardyomyopathy; Human cirrhosis.

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