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

Combined therapies vs monotherapies for the first variceal bleeding in high-risk varices

This month's Journal of Gastroenterology & Hepatology compares combined therapies with monotherapies for the first variceal bleeding in patients with high-risk varices.

News image

The effect of combined therapies (among non-selected beta-blockers [NSBB], endoscopic therapy, and other treatments) on the first variceal bleeding has been evaluated in several randomized controlled trials previously, and the results were controversial.

Dr Guohong Han and colleagues from China performed this meta-analysis to assess the effect of combined therapies in patients with high-risk varices without previous variceal bleeding.

The Cochrane Library, The Cochrane Hepato-Biliary Group Controlled Trials Register, MEDLINE, and EMBASE were searched for eligible trials. Manual searches were also performed for additional studies.

Upper gastrointestinal bleeding, variceal bleeding, mortality, and adverse events were evaluated as end-points by meta-analysis.

Adverse events occurred more frequently in the combined therapy groups
Journal of Gastroenterology & Hepatology

The researchers identified 12 randomized controlled trials with 1571 patients.

Compared with the NSBB (propranolol or nadolol) or endoscopic therapy alone, all of the combined therapies did not demonstrate significant improvements in variceal bleeding, total upper gastrointestinal bleeding, and mortality.

The research team found that only the combinations of isosorbide-mononitrate or spironolactone with NSBB tended to decrease the risk of variceal bleeding when compared with the use of NSBB alone.

The team observed adverse events more frequently in the combined therapy groups.

Dr Han's team concludes, "Based on the available evidences, no combined therapy can be recommended as the first-line treatment for the primary prevention of variceal bleeding currently."

"Further studies with large sample sizes and long-term follow up are warranted."

J Gastroenterol Hepatol 2014: 29(3): 442–452
20 March 2014

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

 26 November 2014

Advanced search
 26 November 2014 
Fertility in women with celiac disease
 26 November 2014 
Detection of gastric precancerous conditions
 26 November 2014 
Vegetables and garlic and colorectal cancer risk
 25 November 2014 
Esophagogastric junction of children with GERD
 25 November 2014 
Symptom activity index for eosinophilic esophagitis
 25 November 2014 
Placebo response rate in fistulizing Crohn's
 24 November 2014 
Nasoenteric tube feeding in acute pancreatitis
 24 November 2014 
Corticosteroids and infections in elderly-onset IBD
 24 November 2014 
Adhesions in abdominal and pelvic surgery
 21 November 2014 
Hepatic involvement in IgG4-related disease
 21 November 2014 
Mortality of chemoembolization in hepatocellular carcinoma
 21 November 2014 
Skin cancer in ulcerative colitis patients
 20 November 2014 
Global measures in chronic idiopathic constipation
 20 November 2014 
Macrophage activation in alcoholic hepatitis
 20 November 2014 
Covert hepatic encephalopathy and survival
 19 November 2014 
Thiopurine withdrawal in IBD
 19 November 2014 
Esophageal narrowing in esophageal eosinophilia
 19 November 2014 
Second intestinal resection in Crohn's
 18 November 2014 
Colorectal neoplasia and vitamin D
 18 November 2014 
Food-associated changes in the intestinal mucosa in IBS
 18 November 2014 
Alternative medicine use by US adults
 17 November 2014 
Treatment of obesity in primary care settings
 17 November 2014 
Allergy-related diseases and abdominal pain in childhood
 17 November 2014 
Diagnosis of monogenic very early onset IBD
 14 November 2014 
Second intestinal resection in Crohn's
 14 November 2014 
HCC risk in active stage Hep B
 14 November 2014 
Thiopurine and clinical remission in IBD
 13 November 2014 
Antibiotics and risk of new-onset Crohn’s
 13 November 2014 
Chronic Hep C genotype 1 treatment after relapse
 13 November 2014 
Chemoembolization for hepatocellular carcinoma
 12 November 2014 
Risk of hepatocellular carcinoma
 12 November 2014 
Abdominal symptom severity in chronic idiopathic constipation
 12 November 2014 
Screening colonoscopy
 11 November 2014 
Hepatocellular carcinoma in Hep B with nucleotide analogue
 11 November 2014 
Familial colorectal cancer screening
 11 November 2014 
Fecal microbiota transplant for C. diff
 10 November 2014 
STaples IPAA for ulcerative colitis
 10 November 2014 
Blood stream infections in acute liver failure
 10 November 2014 
Ig4-related disease
 07 November 2014 
Host and viral factors in chronic Hep C
 07 November 2014 
Celiac diagnosis without biopsy
 07 November 2014 
Pricing practices of gastroenterologists
 06 November 2014 

Colorectal surgery postdischarge occurrences and readmissions

 06 November 2014 
Thromboprophylaxis in IBD
 06 November 2014 
Steatosis biomarkers in NAFLD
 05 November 2014 
Readmission risk factors for patients with IBD
 05 November 2014 
Hysterectomy and colonoscopy completion
 05 November 2014 
Adalimumab in Crohn's disease
 04 November 2014 
Gut barrier dysfunction and CNS disorders
 04 November 2014 
Hemospray for nonvariceal upper GI bleeding
 04 November 2014 
Sleep duration and ulcerative colitis
 03 November 2014 
Mucosal pathophysiology in HIV and IBD
 03 November 2014 
Managing bleeding gastroduodenal ulcers
 03 November 2014 
Identifying inflammation in ulcerative colitis
 31 October 2014 
Pregnancy complications in celiac disease
 31 October 2014 
Pediatric NAFLD
 31 October 2014 
C. difficile infection with metronidazole
 30 October 2014 
Cirrhosis in women
 30 October 2014 
Costs in newly diagnosed patients with chronic constipation
 30 October 2014 
Constipation and colorectal cancer

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us