Back to Search
Start Over
Beneficial long term effect of a phosphodiesterase-5-inhibitor in cirrhotic portal hypertension: A case report with 8 years follow-up.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2018 Jan 21; Vol. 24 (3), pp. 438-444. - Publication Year :
- 2018
-
Abstract
- Non-selective beta-blockers are the mainstay of medical therapy for portal hypertension in liver cirrhosis. Inhibitors of phosphodiesterase-5 (PDE-5-inhibitors) reduce portal pressure in the acute setting by > 10% which may suggest a long-term beneficial effect. Currently, there is no available data on long-term treatment of portal hypertension with PDE-5-inhibitors. This case of a patient with liver cirrhosis secondary to autoimmune liver disease with episodes of bleeding from esophageal varices is the first documented case in which a treatment with a PDE-5-inhibitor for eight years was monitored. In the acute setting, the PDE-5-inhibitor Vardenafil lowered portal pressure by 13%. The portal blood flow increased by 28% based on Doppler sonography and by 16% using MRI technique. As maintenance medication the PDE-5-inhibitor Tadalafil was used for eight consecutive years with comparable effects on portal pressure and portal blood flow. There were no recurrence of bleeding and no formation of new varices. Influencing the NO-pathway by the use of PDE-5 inhibitors may have long-term beneficial effects in compensated cirrhosis.<br />Competing Interests: Conflict-of-interest statement: None of the authors declared a conflict of interest.
- Subjects :
- Administration, Oral
Cholangitis, Sclerosing diagnostic imaging
Cholangitis, Sclerosing pathology
Computed Tomography Angiography
Endoscopy, Digestive System
Esophageal and Gastric Varices diagnostic imaging
Esophageal and Gastric Varices etiology
Esophageal and Gastric Varices surgery
Female
Follow-Up Studies
Gastrointestinal Hemorrhage diagnostic imaging
Gastrointestinal Hemorrhage etiology
Gastrointestinal Hemorrhage surgery
Hemodynamics drug effects
Hepatitis, Autoimmune diagnostic imaging
Hepatitis, Autoimmune pathology
Humans
Hypertension, Portal diagnostic imaging
Hypertension, Portal etiology
Hypertension, Portal pathology
Liver Cirrhosis diagnostic imaging
Liver Cirrhosis etiology
Liver Cirrhosis pathology
Middle Aged
Phosphodiesterase 5 Inhibitors pharmacology
Syndrome
Tadalafil pharmacology
Tadalafil therapeutic use
Time Factors
Treatment Outcome
Vardenafil Dihydrochloride pharmacology
Vardenafil Dihydrochloride therapeutic use
Cholangitis, Sclerosing complications
Hepatitis, Autoimmune complications
Hypertension, Portal drug therapy
Liver Cirrhosis drug therapy
Phosphodiesterase 5 Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 24
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 29391766
- Full Text :
- https://doi.org/10.3748/wjg.v24.i3.438