Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Apr 27, 2022; 14(4): 827-845
Published online Apr 27, 2022. doi: 10.4254/wjh.v14.i4.827
Effects and safety of natriuretic peptides as treatment of cirrhotic ascites: A systematic review and meta-analysis
Rasmus Hvidbjerg Gantzel, Mikkel Breinholt Kjær, Peter Jepsen, Niels Kristian Aagaard, Hugh Watson, Lise Lotte Gluud, Henning Grønbæk
Rasmus Hvidbjerg Gantzel, Mikkel Breinholt Kjær, Peter Jepsen, Niels Kristian Aagaard, Hugh Watson, Henning Grønbæk, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus N 8200, Denmark
Lise Lotte Gluud, Gastroenterology Unit, Copenhagen University Hospital, Hvidovre 2650, Denmark
Lise Lotte Gluud, Department of Clinical Medicine, University of Copenhagen, Hvidovre 2650, Denmark
Author contributions: Gluud LL and Grønbæk H contributed equally to the work. All authors contributed to the design of the study. Gantzel RH and Kjær MB acquired the study data; Gantzel RH and Gluud LL performed the statistical analyses; all authors contributed to the interpretation of data; Gantzel RH drafted the manuscript; and all authors critically reviewed and approved the final manuscript.
Conflict-of-interest statement: Grønbæk H has received a research grant (No. ULA04-2019-1) from ADS AIPHIA Development Services AG (Switzerland) to investigate ularitide in patients with refractory ascites. Watson H owns stocks in Sanofi. Gantzel RH, Kjær MB, Jepsen P, and Aagaard NK have nothing to report. Financial support: Grønbæk H has received research funding from Intercept, Abbvie, NOVO Nordisk Foundation, Arla, and ADS AIPHIA Development Services AG. Grønbæk H is an advisory board member for Ipsen and speaker for Norgine. Gluud LL has received grants from Novo Nordisk, Alexion, and Gilead.
PRISMA 2009 Checklist statement: This review was performed in accordance with the PRISMA guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Henning Grønbæk, MD, PhD, Doctor, Professor, Research Associate, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N 8200, Denmark. henngroe@rm.dk
Received: July 5, 2021
Peer-review started: July 5, 2021
First decision: November 11, 2021
Revised: November 22, 2021
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: April 27, 2022
Core Tip

Core Tip: Pharmacotherapies for cirrhotic ascites have remained largely unchanged for the past four decades. 5%-10% of cirrhosis patients with ascites become refractory to available treatments, and the majority of these patients require frequent large-volume paracenteses. This justifies a continued search for new and improved treatments for ascites. This is the first systematic review and meta-analysis to investigate the effects and safety of natriuretic peptides as treatment of cirrhotic ascites. We demonstrate a significant natriuretic effect of intravenously administered atrial natriuretic peptide and summarise the safety findings.