Efficacy of Proton Pump Inhibitors in Cirrhotic Patients With Acute Variceal Bleeding

Launched by WEST CHINA HOSPITAL · Nov 12, 2022

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ClinConnect Summary

This clinical trial is investigating whether proton pump inhibitors (PPIs), a type of medication that reduces stomach acid, can help patients with liver cirrhosis who are experiencing acute variceal bleeding. This bleeding is a serious condition that can occur in people with liver problems, and the study aims to understand if adding PPIs to standard treatment can improve outcomes for these patients.

To participate in the trial, individuals must have liver cirrhosis and must be experiencing acute bleeding from swollen veins in the esophagus, confirmed through an emergency procedure called endoscopy within 24 hours of arrival at the hospital. Eligible participants should be between the ages of 65 and 74 or 29 and 219, and they must agree to follow the study's guidelines and provide consent. However, certain individuals, such as those with specific types of heart or kidney problems, recent cancer diagnoses, or who have used PPIs before admission, will not be eligible. If you or a loved one are facing this challenging situation, this trial may offer an opportunity to explore a potential new treatment approach.

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Eligibility criteria

• Inclusion Criteria:
• • 1. Liver cirrhosis.
• • 2. The etiology of portal hypertension is cirrhosis.
• • 3. Patients presenting with acute esophageal variceal bleeding proven by emergency endoscopy within 24 hours.
• • 4. Be willing to participate in this clinical study, comply with the study requirements and sign the informed consent
• Exclusion Criteria:
• • 1. non-cirrhotic portal hypertension
• • 2. the time from admission to endoscopy was more than 24 hours
• • 3. patients with peptic ulcer or gastroesophageal reflux disease requiring PPI therapy
• • 4. PPI use for more than 2 weeks before admission
• • 5. received endoscopic or interventional therapy within the previous 4 weeks
• • 6. PPI allergy
• • 7. Chronic renal insufficiency (CKD stage 3-5)
• • 8. Severe cardiopulmonary dysfunction (such as heart failure grade 3-4, respiratory failure, etc.)
• • 9. Hepatocellular carcinoma (Barcelona Clinic Liver Cancer (BCLC) stage C and D)
• • 10. other advanced malignancies (life expectancy less than 6 months)
• • 11. Pregnancy