Beta-Blockers to Prevent Gastroesophageal Varices in Patients with Cirrhosis

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Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis.

BACKGROUND Nonselective beta-adrenergic blockers decrease portal pressure and prevent variceal hemorrhage. Their effectiveness in preventing varices is unknown. METHODS We randomly assigned 213 patients with cirrhosis and portal hypertension (minimal hepatic venous pressure gradient [HVPG] of 6 mm Hg) to receive timolol, a nonselective beta-blocker (108 patients), or placebo (105 patients). T...

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A nonselective beta-blocker did not prevent gastroesophageal varices in cirrhosis and portal hypertension.

M e t h o d s Design: Randomized placebo-controlled trial. Allocation: {Concealed}†.* Blinding: Blinded {clinicians, patients, data collectors, outcome assessors, and data analysts}†.* Follow-up period: Median 55 months (range 0 to 99 mo). Setting: 4 centers in Barcelona, Spain; West Haven, Connecticut, and Boston, Massachusetts, USA; and London, United Kingdom. Patients: 213 patients 18 to 74 ...

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Nonselective Beta-blockers in Patients with Cirrhosis: "the Therapeutic Window".

For over 30 years, nonselective beta-blockers (NSBB) have been successfully used for preventing variceal bleeding in patients with cirrhosis and portal hypertension. Nevertheless, recent studies suggest that NSBB may be effective only within a particular "therapeutic window" in patients with advanced liver disease. Outside of this window, in early stages of cirrhosis and in very advanced cirrho...

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Beta-blockers in liver cirrhosis

Since the original description of the effectiveness of β-blockers in lowering the portal pressure and therefore the risk of variceal bleeding, more than 500 articles in the English literature on the use of non selective β-blockers (NSBB) in cirrhosis have been published. The use of NSBB in pre-primary prophylaxis of variceal bleeding is currently not indicated. In primary prophylaxis, patients ...

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Prevention and Management of Gastroesophageal Varices in Cirrhosis

Variceal hemorrhage is one of the major complications of liver cirrhosis associated with significant mortality and morbidity. Its management has evolved over the past decade and has substantially reduced the rate of first and recurrent bleeding while decreasing mortality. In general, treatment of esophageal varices can be divided into three categories: primary prophylaxis (prevention of first e...

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ژورنال

عنوان ژورنال: New England Journal of Medicine

سال: 2005

ISSN: 0028-4793,1533-4406

DOI: 10.1056/nejmoa044456