Method of treating patients with hepatorenal syndrome type 1
First Claim
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1. A method of treating type 1 hepatorenal syndrome (HRS-1), the method comprising:
- identifying a plurality of patients as having HRS-1;
determining that a first patient of the plurality exhibits at least two of the following three criteria for Systemic Inflammatory Response Syndrome (SIRS);
(i) a white blood cell count (WBC) less than 4,000 cells/mm3 or greater than 12,000 cells/mm3,(ii) a heart rate of greater than 90 beats per minute (BPM), and(iii) either a partial pressure of carbon dioxide in the blood (PaCO2)<
32 mmHg or a blood bicarbonate (HCO3) level<
23 mmol/L;
determining that the first patient does not have overt sepsis, septic shock, or uncontrolled infection;
determining that, because the first patient exhibits at least two of the three criteria and does not have overt sepsis, septic shock, or uncontrolled infection, the HRS-1 of the first patient is likely to respond to treatment with terlipressin;
administering to the first patient an amount of terlipressin effective to treat HRS-1 in the first patient;
determining that a second patient of the plurality exhibits only one or none of the three criteria or has overt sepsis, septic shock, or uncontrolled infection;
determining that, because the second patient does not exhibit at least two of the three criteria or has overt sepsis, septic shock, or uncontrolled infection, the HRS-1 of the second patient is unlikely to respond to treatment with terlipressin;
excluding the second patient from treatment with terlipressin determining that a third patient of the plurality has overt sepsis, septic shock, or uncontrolled infection; and
excluding the third patient from treatment with terlipressin.
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Abstract
The principles and embodiments of the present disclosure relate to methods for using terlipressin to treat a patient having impaired renal function associated with liver disease. A patient identified as suffering from HRS-1 is tested to determine if the patient meets at least two out of three criteria, wherein the three criteria include a WBC<4 or >12 cells/μL; HR>90 bpm; and any one of HCO3<21 mmol/L or PaCO2<32 mmHg or >20 breaths per minute. If the patient meets at least two of the criteria, he or she is administered terlipressin in an amount effective to produce a reduction in serum creatinine of at least 1.0 mg/dL.
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Citations
28 Claims
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1. A method of treating type 1 hepatorenal syndrome (HRS-1), the method comprising:
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identifying a plurality of patients as having HRS-1; determining that a first patient of the plurality exhibits at least two of the following three criteria for Systemic Inflammatory Response Syndrome (SIRS); (i) a white blood cell count (WBC) less than 4,000 cells/mm3 or greater than 12,000 cells/mm3, (ii) a heart rate of greater than 90 beats per minute (BPM), and (iii) either a partial pressure of carbon dioxide in the blood (PaCO2)<
32 mmHg or a blood bicarbonate (HCO3) level<
23 mmol/L;determining that the first patient does not have overt sepsis, septic shock, or uncontrolled infection; determining that, because the first patient exhibits at least two of the three criteria and does not have overt sepsis, septic shock, or uncontrolled infection, the HRS-1 of the first patient is likely to respond to treatment with terlipressin; administering to the first patient an amount of terlipressin effective to treat HRS-1 in the first patient; determining that a second patient of the plurality exhibits only one or none of the three criteria or has overt sepsis, septic shock, or uncontrolled infection; determining that, because the second patient does not exhibit at least two of the three criteria or has overt sepsis, septic shock, or uncontrolled infection, the HRS-1 of the second patient is unlikely to respond to treatment with terlipressin; excluding the second patient from treatment with terlipressin determining that a third patient of the plurality has overt sepsis, septic shock, or uncontrolled infection; and excluding the third patient from treatment with terlipressin. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A method of increasing the effectiveness of terlipressin for the treatment of impaired renal function associated with liver disease, comprising:
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identifying a plurality of patients with end-stage liver disease and impaired renal function; testing the plurality of patients to determine whether each meets each of the following three criteria (i)-(iii); (i) a white blood cell count either less than 4,000 cells/mm3 or greater than 12,000 cells/mm3, (ii) a heart rate of greater than 90 beats per minute, and (iii) either (a) a partial pressure of carbon dioxide in the blood (PaCO2) of <
32 mmHg or (b) a blood bicarbonate HCO3 level of <
23 mmol/L or (c) tachypnea with more than 20 breaths per minute;determining that a first patient of the plurality meets at least two of the three criteria; determining that the first patient does not have overt sepsis, septic shock, or uncontrolled infection; determining that, because the first patient meets at least two of the three criteria and does not have overt sepsis, septic shock, or uncontrolled infection, the first patient'"'"'s renal function is more likely to improve upon treatment with terlipressin than if the first patient exhibited only one or none of the three criteria; administering to the first patient an amount of terlipressin effective to improve the first patient'"'"'s renal function; determining that a second patient of the plurality meets only one or none of the three criteria or has overt sepsis, septic shock, or uncontrolled infection; determining that, because the second patient does not meet at least two of the three criteria or has overt sepsis, septic shock, or uncontrolled infection, the second patient'"'"'s renal function is less likely to respond to treatment with terlipressin than if the second patient exhibited at least two of the three criteria; and excluding the second patient from treatment with terlipressin. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28)
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Specification