Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Carvedilol for primary prophylaxis of variceal bleeding in cirrhosis

The most recent issue of Gut investigates the use of carvedilol for primary prophylaxis of variceal bleeding in cirrhotic patients with hemodynamic non-response to propranolol.

News image

Non-selective β-blockers or endoscopic band ligation are recommended for primary prophylaxis of variceal bleeding in patients with esophageal varices.

Additional α-adrenergic blockade (as by carvedilol) may increase the number of patients with hemodynamic response.

Professor Markus Peck-Radosavljevic and colleagues from Austria examined patients with esophageal varices undergoing measurement of HVPG before and under propranolol treatment.

HVPG responders were kept on propranolol, while non-responders were placed on carvedilol.

Carvedilol responders continued treatment, while non-responders to carvedilol underwent endoscopic band ligation.

Bleeding rates were 11% in patients on propranolol
Gut

The research team's primary aim was hemodynamic response rates to carvedilol in propranolol non-responders.

The team found that 36% of patients showed a HVPG response to propranolol.

Among the propranolol non-responders 56% eventually achieved a hemodynamic response with carvedilol, while 44% of patients were finally treated with endoscopic band ligation.

The team found that the decrease in HVPG was significantly greater with carvedilol than with propranolol.

During a 2 year follow-up bleeding rates were 11% in patients on propanolol versus 5% in Carvedilol responders versus 25% with endoscopic band ligation.

The team observed fewer episodes of hepatic decompensation, and significantly lower mortality were observed in hemodynamic responders compared to the endoscopic band ligation group.

Professor Peck-Radosavljevic's team concludes, "Carvedilol leads to a significantly greater decrease in HVPG than propranolol."

"Using carvedilol for primary prophylaxis a substantial proportion of non-responders to propranolol can achieve a haemodynamic response, which is associated with improved outcome with regard to prevention of variceal bleeding, hepatic decompensation and death."

Gut 2013; 62: 1634-1641
21 October 2013

Go to top of page Email this page Email this page to a colleague

 05 May 2015

Advanced search
 05 May 2015 
Fatigue in primary sclerosing cholangitis
 05 May 2015 
Annual CT scans after esophagectomy for cancer
 05 May 2015 
Prevalence of eosinophilic esophagitis
 04 May 2015 
Stress resilience and peptic ulcer disease
 04 May 2015 
Menarche and NAFLD
 04 May 2015 
Endoscope storage and microbial colonization
 01 May 2015 
Sleep and physical activity measured in Crohn's
 01 May 2015 
NAFLD progression from steatosis to fibrosing-steatohepatitis
 01 May 2015 
Dietary supplement hepatotoxicity
 30 April 2015 
Botulinum toxin A for the treatment of obesity
 30 April 2015 
Neoadjuvant chemoradiotherapy for esophageal cancer
 30 April 2015 
Risk factors for primary sclerosing cholangitis
 29 April 2015 
Liver enzyme elevations after anti-TNF therapy in IBD

 29 April 2015 
Hepatocellular carcinoma surveillance in HBV
 29 April 2015 
Response to sorafenib in hepatocellular carcinoma
 28 April 2015 
Risk factors of hepatocellular carcinoma
 28 April 2015 
Clinical outcomes after esophagectomy
 28 April 2015 
Alcohol drinking and risk of liver cirrhosis
 23 April 2015 
Gut microbiota modulation for alcoholic liver disease
 23 April 2015 
Moderate sodium restriction diet in cirrhosis
 23 April 2015 
Gastroesophageal junction disruption and obesity
 22 April 2015 
Hepatitis and mortality in hospitalized patients
 22 April 2015 
Magnetic sphincter augmentation for GERD
 22 April 2015 
Drug, herbal and dietary supplement hepatotoxicity
 21 April 2015 
Risk factors of postpartum bowel changes
 21 April 2015 
Tracking colonoscopy surveillance intervals
 21 April 2015 
PPI increases risk of cryptogenic liver abscess
 20 April 2015 
IBS after traveller's diarhea
 20 April 2015 
Economic impact of C. diff infection
 20 April 2015 
Adherence to Hep C treatments
 17 April 2015 
Synchronous colorectal advanced neoplasia
 17 April 2015 
PNPLA3 polymorphisms and NAFLD risk
 17 April 2015 
MELD score and colorectal resection
 16 April 2015 
Bleeding risk in colonic diverticulosis
 16 April 2015 
Minority use of high-volume hospitals for colorectal cancer
 16 April 2015 
Sleep and IBD
 15 April 2015 
Treatment of hepatocellular carcinoma
 15 April 2015 
Score predicts malignant bile duct obstruction
 15 April 2015 
Increased risk of Barrett esophagus
 14 April 2015 
Improving colorectal cancer screening uptake
 14 April 2015 
Colorectal cancer presenting under the age of 50
 14 April 2015 
Functional constipation vs constipation predominant IBS
 13 April 2015 
Fecal transplant for C. difficile
 13 April 2015 
Immune based treatments for HCC
 13 April 2015 
CRP and acute diverticulitis
 10 April 2015 
Hypnotherapy for IBS
 10 April 2015 
Adjuvant therapy after rectal cancer
 10 April 2015 
Viral outcomes in HCV infection
 09 April 2015 
Male IBD patients wishing to conceive
 09 April 2015 
Screening programs based on the fecal immunochemical test
 09 April 2015 
Management of esophageal food impaction
 08 April 2015 
Ambulatory hemorrhoidal surgery
 08 April 2015 
Iron fortification and gut inflammation
 08 April 2015 
Nonceliac gluten sensitivity
 07 April 2015 
Treatment of Hep C virus
 07 April 2015 
Interventions for eosinophilic esophagitis
 07 April 2015 
Endoscopic managements of GI bleeds
 06 April 2015 
Risk stratifying Barrett's esophagus
 06 April 2015 
Cost-effectiveness of HCV
 06 April 2015 
Treatment for rectal cancer

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us