FDA has approved the vasopressin receptor agonist terlipressin (Terlivaz, Mallinckrodt) injection to improve kidney function in adults with hepatorenal syndrome (HRS) with rapid reduction in kidney function. This is the first FDA-approved medication for this condition. HRS, progressive deterioration in kidney function in people with advanced liver disease, is most common in those with advanced cirrhosis and ascites, FDA said. The prognosis is very poor, particularly if patients’ liver disease is not treated with liver transplantation. Rising levels of serum creatinine in patients with HRS can indicate worsening kidney function.
“The COVID-19 crisis has exposed major weaknesses in the UN-based multilateral system, resulting from excessive nationalism, tensions among the major powers, chronic underfinancing of global public goods including the UN system itself, lack of flexibility of intellectual property regimes to ensure that global public goods are available to all, lack of adequate sustainable development financing for [low-income and middle-income countries], and the erosion of political support for multilateral solutions by the major powers,” concludes a report from the Lancet Commission. “Despite major efforts to stimulate recovery and a just transition to sustainable development, the lack of ambition in the global response to COVID-19 is like that of other pressing global challenges, such as the climate emergency; the loss of global biodiversity; the pollution of air, land, and water; the persistence of extreme poverty in the midst of plenty; and the large-scale displacement of people as a result of conflicts, poverty, and environmental stress.”