Association of Pretreatment Hepatic Function Markers with Clazosentan-Associated Fluid Retention in Patients…

Abstract

Clazosentan is used to prevent cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH), but it is often associated with fluid retention-related adverse events. This retrospective study investigated the relationship between the pretreatment Albumin-Bilirubin (ALBI) score and clazosentan-associated fluid retention in patients with SAH. Patients who newly initiated clazosentan treatment at Saga University Hospital between April 2022 and March 2026 were enrolled. Clinical characteristics and laboratory data were retrospectively obtained from electronic medical records. Patients were divided into fluid retention and non-fluid retention groups, and factors associated with fluid retention were analyzed. A total of 61 patients were included, with clazosentan-associated fluid retention observed in 32 patients (52.5%). The ALBI score was significantly higher (i.e., less negative) in the fluid retention group than in the non-fluid retention group (median: -2.62 vs. -2.94, p = 0.007). Multivariate logistic regression analysis revealed that an elevated ALBI score was independently associated with fluid retention (odds ratio per 0.1-point increase: 1.17; 95% confidence interval: 1.01-1.37; p = 0.03). Additionally, patients requiring loop diuretics for fluid management had significantly higher ALBI scores than those not requiring them (median: -2.61 vs. -2.91; p = 0.006). These findings suggest that an elevated pretreatment ALBI score may be linked to an increased risk of clazosentan-associated fluid retention. Further validation in patients with varying degrees of hepatic function is warranted to establish its clinical utility.

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BibTeX

@article{oguni2026association,
  title = {{Association of Pretreatment Hepatic Function Markers with Clazosentan-Associated Fluid Retention in Patients with Subarachnoid Hemorrhage}},
  author = {Kinuka Oguni and Rintaro Sogawa and Yuki Nakano and Shuko Tobita and Atsushi Ogata and Tatsuya Abe and Chisato Shimanoe},
  journal = {Biological and Pharmaceutical Bulletin},
  year = {2026},
  month = aug,
  doi = {10.1248/bpb.b26-00344},
  url = {https://www.jstage.jst.go.jp/article/bpb/49/8/49_b26-00344/_article},
  note = {CC BY-NC},
}

RIS

TY  - JOUR
TI  - Association of Pretreatment Hepatic Function Markers with Clazosentan-Associated Fluid Retention in Patients with Subarachnoid Hemorrhage
AU  - Kinuka Oguni
AU  - Rintaro Sogawa
AU  - Yuki Nakano
AU  - Shuko Tobita
AU  - Atsushi Ogata
AU  - Tatsuya Abe
AU  - Chisato Shimanoe
PY  - 2026
DA  - 2026/08/29
JO  - Biological and Pharmaceutical Bulletin
DO  - 10.1248/bpb.b26-00344
UR  - https://www.jstage.jst.go.jp/article/bpb/49/8/49_b26-00344/_article
AB  - Clazosentan is used to prevent cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH), but it is often associated with fluid retention-related adverse events. This retrospective study investigated the relationship between the pretreatment Albumin-Bilirubin (ALBI) score and clazosentan-associated fluid retention in patients with SAH. Patients who newly initiated clazosentan treatment at Saga University Hospital between April 2022 and March 2026 were enrolled. Clinical characteristics and laboratory data were retrospectively obtained from electronic medical records. Patients were divided into fluid retention and non-fluid retention groups, and factors associated with fluid retention were analyzed. A total of 61 patients were included, with clazosentan-associated fluid retention observed in 32 patients (52.5%). The ALBI score was significantly higher (i.e., less negative) in the fluid retention group than in the non-fluid retention group (median: -2.62 vs. -2.94, p = 0.007). Multivariate logistic regression analysis revealed that an elevated ALBI score was independently associated with fluid retention (odds ratio per 0.1-point increase: 1.17; 95% confidence interval: 1.01-1.37; p = 0.03). Additionally, patients requiring loop diuretics for fluid management had significantly higher ALBI scores than those not requiring them (median: -2.61 vs. -2.91; p = 0.006). These findings suggest that an elevated pretreatment ALBI score may be linked to an increased risk of clazosentan-associated fluid retention. Further validation in patients with varying degrees of hepatic function is warranted to establish its clinical utility.
SN  - 1347-5215
SN  - 0918-6158
ER  -

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