Midodrine in Liver Cirrhosis With Ascites: A Systematic Review and Meta-Analysis

Area of Science:

• Gastroenterology and Hepatology
• Pharmacology
• Clinical Trials

Background:

• Ascites is a frequent complication of liver cirrhosis.
• Midodrine, a vasoconstrictor, shows promise in managing circulatory dysfunction and ascites.
• Understanding midodrine's efficacy in cirrhotic ascites is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the role and efficacy of midodrine in treating ascites associated with liver cirrhosis.
• To compare midodrine's effects against standard medical treatment and albumin therapy.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials.
• Searched Scopus, Embase, PubMed, and PubMed Central databases for relevant studies.
• Analyzed data using Odds Ratio (OR) and Mean Difference (MD) with 95% Confidence Intervals (CI).

Main Results:

• Midodrine significantly improved mean arterial pressure (MAP) and MELD scores compared to standard medical treatment.
• Significant improvements were observed in plasma renin activity and aldosterone concentration.
• No significant differences in mortality or serum creatinine were noted compared to standard medical treatment; midodrine was non-inferior to albumin.

Conclusions:

• Midodrine monotherapy significantly improves clinical parameters in cirrhotic ascites patients versus standard care.
• Midodrine demonstrates non-inferiority to albumin in this patient population.
• Further research on combining midodrine with albumin is warranted for optimal patient benefit.