Randomised clinical study: the effects of oral taurine 6g/day vs placebo on portal hypertension

BackgroundThe amino sulphonic acid taurine reduces oxidative endoplasmatic reticulum stress and inhibits hepatic stellate cell activation, which might lead to reduction of portal pressure in cirrhosis. AimTo assess the haemodynamic effects of taurine supplementation in patients with cirrhosis and varices. MethodsPatients with hepatic venous pressure gradient (HVPG) 12mm Hg were included in this prospective proof of concept study. Concomitant nonselective beta-blockers therapy was not allowed. Patients received either 4weeks of oral taurine (6g/day), or placebo, prior to evaluation of HVPG response. ResultsThirty patients were screened and 22 included in the efficacy analysis (12 taurine/10 placebo; 64% male, mean age: 5211years, Child A: 9%, B:64%, C:27%, ascites:68%). In the taurine group, mean HVPG dropped from 20mm Hg (+/- 4) at baseline to 18mm Hg (+/- 4) on day 28 (mean relative change: -12%, P=.0093). In the placebo group, mean HVPG increased from 20 mm Hg (+/- 5) at baseline to 21mm Hg (+/- 5) on day 28 (mean relative change:+2%, P=.4945). Taurine had no significant effects on systemic haemodynamics. Seven of 12 patients (58%) on taurine achieved a HVPG response >10%, compared to none in the placebo group (P=.0053). In a multivariate linear model, HVPG reduction was significantly larger in the taurine group compared to placebo group (P=.0091 and P=.0109 for absolute and relative change respectively). Treatment-related adverse events included gastrointestinal discomfort and fatigue, and were usually mild and comparable between treatment groups. ConclusionTaurine is safe and may reduce portal pressure in cirrhotic patients. More studies on the underlying mechanisms of action and long-term effects of taurine supplementation are warranted.