Carvedilol vs. Propranolol in Second Prophylaxis of Variceal Bleeding

Launched by WEST CHINA HOSPITAL · Dec 14, 2022

Keywords

ClinConnect Summary

Non-selective beta blockers combined with endoscopic variceal band ligation (EVL) is the most effective methods for the prevention of variceal bleeding. Carvedilol has emerged as the preferred NSBB for treating portal hypertension in compensated cirrhosis due to strong evidence demonstrating that it has a more pronounced effect than propranolol to reduce the hepatic vein pressure gradient (HVPG), together with good patient acceptability and safety profile. However, No data from prospectively designed trials are available on the efficacy of carvedilol in the secondary prophylaxis of variceal...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Between 18 and 80 years old;
• • With liver cirrhosis diagnosed by previous biopsy or by clinical criteria, and analytical image;
• • At least 5 days after index variceal bleeding;
• • Informed consent.
• Exclusion Criteria:
• • Refusal to participate in the study;
• • Portal hypertension resulting from other causes than liver cirrhosis;
• • More than 42 days after index variceal bleeding;
• • Bleeding from cardiofundal gastric varices;
• • Portal venous thrombosis \>50% of the portal vein trunk;
• • Contraindications to beta-blockers (asthma, chronic obstructive pulmonary disease, atrioventricular block, heart failure, bradycardia with HR ≤40 bpm, arteria hypotension with systolic blood pressure \<90 mm Hg, peripheral arterial disease, uncontrolled diabetes);
• • Prior NSBB+EVL combined treatment, TIPS implantation or surgical shunt as secondary prophylaxis of variceal bledding;
• • Chronic kidney disease;
• • Pregnancy or lactation;
• • Neoplastic disease.

Trial Officials