Combination of Granulocyte Colony-Stimulating Factor and Erythropoietin Improves Outcomes of Patients With Decompensated Cirrhosis

摘要: Background & Aims Patients with decompensated cirrhosis have significantly reduced survival without liver transplantation. Granulocyte colony-stimulating factor (G-CSF) has been shown to increase in patients acute-on-chronic failure, and erythropoietin promoted hepatic regeneration animal studies. We performed a double-blind, randomized, placebo-controlled trial determine whether co-administration of these growth factors improved outcomes for advanced cirrhosis. Methods In prospective study, consecutive seen at the Institute Liver Biliary Sciences, New Delhi (from May 2011 through June 2012) were randomly assigned groups given subcutaneous G-CSF (5 μg/kg/d) 5 days then every third day (12 total doses), along darbopoietin α(40 mcg/wk) 4 weeks (GDP group, n = 29), or only placebos (control 26). All also received standard medical therapy followed 12 months. Histology was on biopsies. The primary end point Results Baseline characteristics comparable; alcohol intake most common etiology A higher proportion GDP group than controls survived until months (68.6% vs 26.9%; P  = .003). At months, Child-Turcotte Pugh scores by 48.6% GDP group 39.1% control from baseline (  = .001); Model End Stage Disease 40.4% 33%, respectively .03). need large-volume paracentesis compared .005). No major adverse events observed either group. Conclusions single-center randomized trial, larger combination α more placebo. severity sepsis greater extent Clinicaltrials.gov ID: NCT01384565.