Evolving Paradigms in Albumin Therapy For Decompensated Cirrhosis: Highlights from the EASL Congress 2025

The PRECIOSA trial, a large-scale, multicentre, Phase III randomised controlled study, presented top-line results evaluating the efficacy of long-term albumin therapy in patients with cirrhosis, prior or current ascites, and acute decompensation. 1 This trial enrolled 410 patients from 14 countries, randomising them to receive either standard medical treatment alone, or standard medical treatment plus Albutein (Grifols, Barcelona, Spain) 20% (1.5 g/kg every 10 days for up to 12 months).While the primary endpoint of 1-year transplantfree survival was not met with statistical significance (hazard rate: 0.80; 95% CI: 0.58-1.10), the study nonetheless revealed promising trends.Notably, the incidence of disease-related complications was significantly lower in the treatment arm, with marked reductions in cirrhosis-related complications, such as spontaneous bacterial peritonitis (odds ratio 0.28; 95% CI: 0.09-0.86)and hepatorenal syndrome (odds ratio 0.24; 95% CI: 0.09-0.64).Importantly, the safety profile of albumin was favourable, with no new safety signals.