Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 06 May 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy 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

 06 May 2016 
Managing acute lower GI bleeding
 06 May 2016 
Recurrent pancreatitis after acute pancreatitis
 06 May 2016 
Risk factors in peptic ulcer bleeding
 05 May 2016 
Genetics in early-early-onset IBD
 05 May 2016 
Reductions in quality of screening colonoscopies
 05 May 2016 
Chemoradiotherapy vs chemotherapy for pancreatic cancer
 04 May 2016 
Bismuth and H. pylori eradication
 04 May 2016 
Chromoendoscopy vs colonoscopy for dysplasia in colitis
 04 May 2016 
Anti-TNF therapy for IBD
 03 May 2016 
Surgery vs medical therapy for GERD
 03 May 2016 
Vedolizumab for IBD
 03 May 2016 
PPIs and gut microbiota
 02 May 2016 
Resection of colorectal polyps
 02 May 2016 
Genetic variant that increase NAFLD risk
 02 May 2016 
Mycophenolate mofetil as first-line treatment of autoimmune hepatitis
 29 April 2016 
Crohn's disease associated genes
 29 April 2016 
Simvastatins and survival in cirrhosis
 29 April 2016 
HCV infection in Baby Boomers with Medicare
 28 April 2016 
Racial disparities in survival from colon cancer
 28 April 2016 
Diarrheal diseases in children
 28 April 2016 
Birth outcomes in women with IBD receiving assisted reproduction
 27 April 2016 
Dust mite and human GI tract
 27 April 2016 
Ultra-short celiac disease
 27 April 2016 
Celiac disease in adults
 26 April 2016 
Polyp detection during colonoscopy
 26 April 2016 
Guidelines for nutrition therapy in hospitalized patients
 26 April 2016 
IBS and microscopic colitis
 25 April 2016 
Estrogen deficiency and fibrosis risk in women with NAFLD
 25 April 2016 
Abrupt interruption of beta-blockers in cirrhosis 
 25 April 2016 
Acceptance of Liver transplant center organ offers
 22 April 2016 
Novel method to regenerate the esophagus
 22 April 2016 
Relapse after antiviral treatment in Hep B
 22 April 2016 
Microscopic colitis with NSAIDs and PPIs
 11 April 2016 
Infliximab vs adalimumab in ulcerative colitis
 11 April 2016 
H. pylori in treatment-naïve children
 11 April 2016 
Admissions times and outcomes for ERCP cholangitis
 08 April 2016 
Endoscopic treatment of Crohn's strictures
 08 April 2016 
Nutrition therapy in the hospitalized patient
 08 April 2016 
H.pylori effects on pediatric gastric mucosa
 07 April 2016 
CVD changes after TIPSS
 07 April 2016 
Transanal mesorectal resection for rectal cancer
 07 April 2016 
HBV during immunosuppressive therapies
 06 April 2016 
Adherence to colorectal cancer screening strategies
 06 April 2016 
Duodenal bulb biopsies in childhood celiac disease diagnosis
 06 April 2016 
Lymph node metastasis in early gastric cancer
 05 April 2016 
Colorectal cancer risk with serrated polyps
 05 April 2016 
IBS in the US military
 05 April 2016 
Changes in blood flow in cirrhosis
 04 April 2016 
Noninvasive diagnosis of celiac disease
 04 April 2016 
Metallic vs plastic stents for benign biliary strictures
 04 April 2016 
Adherence to quality indicators improves clinical outcomes in ascites
 01 April 2016 
Intensive enteral nutrition and severe alcoholic hepatitis
 01 April 2016 
Prognosis after colorectal cancer resection with peritoneal metastasis
 01 April 2016 
Colorectal cancer risk with non-malignant colonoscopy findings
 31 March 2016 
Management of Barrett’s esophagus
 31 March 2016 
Anesthesia services during colonoscopy
 31 March 2016 
Alcohol and glucose tolerance in NAFLD
 30 March 2016 
Electronic learning system for colon capsule endoscopy
 30 March 2016 
Gastric cancer screening
 30 March 2016 
Depression and symptoms in IBS

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us