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): 442452
20 March 2014

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

 25 October 2014

Advanced search
 24 October 2014 
NSAIDs and Barrett's risk
 24 October 2014 
Olmesartan-associated enteropathy
 24 October 2014 
Opioid use in IBD
 23 October 2014 
Advancing the field of functional GI disorders
 23 October 2014 
Outcomes in hospitalized patients with GI bleeding
 23 October 2014 
Thiopurines and colorectal cancer risk in IBD
 22 October 2014 
Early-TIPSS placement prevents rebleeding
 22 October 2014 
Liver fibrosis prognostic biomarkers in type-2 diabetes
 22 October 2014 
H pylori eradication with multiple drug resistance
 21 October 2014 
Alcohol and Barrett's
 21 October 2014 
Scoring systems for critically ill cirrhotic patients
 21 October 2014 
Aspirin and NAFLD
 20 October 2014 
Adalimumab in secondary loss of response in Crohn's
 20 October 2014 
Drug resistant H pylori eradication
 20 October 2014 
Omega-3 and colorectal cancer
 17 October 2014 
Tumor necrosis factor-alpha inhibitors and pregnancy in IBD
 17 October 2014 
Colorectal testing utilization
 17 October 2014 
Fecal microbiota composition in postinfectious IBS
 16 October 2014 
Risk of Barrett's esophagus
 16 October 2014 
Aspirin tablets and colorectal tumours
 16 October 2014 
Economic impact of IBS
 15 October 2014 
Achieving competency at colonoscopy
 15 October 2014 
Preparation for surgery in Crohn's
 15 October 2014 
Bowel preparations
 14 October 2014 
Colorectal testing utilization in commercially insured US adults
 14 October 2014 
Sustained response to infliximab
 14 October 2014 
IBD management during pregnancy
 13 October 2014 
Predicting PPI response in GERD-related cough
 13 October 2014 
Probiotics in IBS
 13 October 2014 
Use of azathioprine in IBD
 10 October 2014 
NAFLD in the Veterans Administration population
 10 October 2014 
Predictors for cecal insertion time
 10 October 2014 
Liver injury from herbals and dietary supplements
 09 October 2014 
Postoperative adhesions in digestive surgery
 09 October 2014 
Methotrexate-related liver disease and metabolic syndrome
 09 October 2014 
Biomarkers of acetaminophen overdose patients
 08 October 2014 
Gluten introduction in high risk children
 08 October 2014 
Vitamin D and HCC
 08 October 2014 
Feeding intervention in celiac disease infants
 07 October 2014 
Infliximab in pediatric perianal Crohn's
 07 October 2014 
Omega-3 and NAFLD
 07 October 2014 
Endoscopic submucosal dissection in the colorectum 
 06 October 2014 
Clinical indications for computed tomographic colonography
 06 October 2014 
Certolizumab pegol in the treatment of Crohn's
 06 October 2014 
Costs of telaprevir therapy for Hep C
 03 October 2014 
Depression and liver transplantation
 03 October 2014 
Orange juice intake during bowel preparation
 03 October 2014 
HCV and diabetes
 02 October 2014 
Predictive model of Hep C disease progression
 02 October 2014 
IPAA with or without preoperative radiation
 02 October 2014 
Person-to-person transmission of norovirus
 01 October 2014 
Prevention of postop Crohn's
 01 October 2014 
Cecal intubation time during colonoscopy
 01 October 2014 
Anti-TNFa therapies during pregnancy in IBD
 30 September 2014 
Autoimmune hepatitis
 30 September 2014 
Medication use in patients with chronic Hep C
 30 September 2014 
Gastric cancer according to H pylori infection status
 29 September 2014 
Drug exposure and microscopic colitis
 29 September 2014 
Peptic ulcer bleeding after PPI treatment
 29 September 2014 
Intestinal tuberculosis vs Crohn's disease

Blackwell Publishing


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