Acute variceal bleeding: Pharmacological treatment and primary/secondary prophylaxis

Best Practice and Research: Clinical Gastroenterology

Volumn 22, Issue 2, 2008, Pages 279-294

  Dell'Era, A ^b   de Franchis, R ^b   Iannuzzi, F ^a  

^a UNIVERSITY OF MILAN   (Italy)

^b NONE

Author keywords

liver cirrhosis; prophylaxis; therapy; variceal bleeding

Indexed keywords

AMINOGLYCOSIDE ANTIBIOTIC AGENT; ANGIOPEPTIN; ANTIBIOTIC AGENT; ANTIFIBRINOLYTIC AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CEFTRIAXONE; CEPHALOSPORIN DERIVATIVE; DESMOPRESSIN; GLYCERYL TRINITRATE; ISOSORBIDE 5 NITRATE; ISOSORBIDE DINITRATE; NADOLOL; NITRATE; NORFLOXACIN; OCTREOTIDE; ORGANIC NITRATE; PLACEBO; PROPRANOLOL; QUINOLINE DERIVED ANTIINFECTIVE AGENT; RECOMBINANT BLOOD CLOTTING FACTOR 7A; SEROTONIN ANTAGONIST; SOMATOSTATIN; SOMATOSTATIN DERIVATIVE; SPIRONOLACTONE; TERLIPRESSIN; TIMOLOL; UNINDEXED DRUG; VAPREOTIDE; VASOACTIVE AGENT; VASOPRESSIN;

ABDOMINAL CRAMP; ABDOMINAL PAIN; ANGINA PECTORIS; ANTIBIOTIC THERAPY; ARTICLE; ASPIRATION PNEUMONIA; BACTEREMIA; BACTERIAL INFECTION; BLOOD CLOTTING DISORDER; BRADYCARDIA; BRAIN DISEASE; BRONCHOSPASM; CEREBROVASCULAR ACCIDENT; CLINICAL TRIAL; CONTINUOUS INFUSION; DIARRHEA; DRUG CHOICE; DRUG CONTRAINDICATION; DRUG DOSE INCREASE; DRUG DOSE TITRATION; DRUG FEVER; DRUG HALF LIFE; DRUG INDUCED HEADACHE; DRUG MECHANISM; DRUG METABOLISM; DRUG SUBSTITUTION; DRUG WITHDRAWAL; DYSPHAGIA; ENDOSCOPIC SCLEROTHERAPY; ESOPHAGOSCOPY; ESOPHAGUS ULCER; ESOPHAGUS ULCER HEMORRHAGE; ESOPHAGUS VARICES BLEEDING; FATIGUE; HEART ARRHYTHMIA; HEART ATRIUM FIBRILLATION; HEART FAILURE; HEART INFARCTION; HEART MUSCLE ISCHEMIA; HEMOSTASIS; HIGH RISK PATIENT; HUMAN; HYPERGLYCEMIA; HYPERTENSION; HYPONATREMIA; HYPOTENSION; INTESTINE ISCHEMIA; KIDNEY FAILURE; LIBIDO DISORDER; LIMB ISCHEMIA; LIVER CIRRHOSIS; LOW DRUG DOSE; LYMPHANGITIS; NAUSEA; NEPHROTOXICITY; NONHUMAN; PATIENT COMPLIANCE; PORTAL HYPERTENSION; PORTAL VEIN BLOOD PRESSURE; PRIMARY PREVENTION; RECOMMENDED DRUG DOSE; SECONDARY PREVENTION; SEIZURE; SEPSIS; THORAX PAIN; UNSPECIFIED SIDE EFFECT;

ACUTE DISEASE; ADRENERGIC BETA-ANTAGONISTS; ANTIBIOTIC PROPHYLAXIS; DRUG THERAPY, COMBINATION; ESOPHAGEAL AND GASTRIC VARICES; HUMANS; HYPERTENSION, PORTAL; LIVER CIRRHOSIS; LYSINE VASOPRESSIN; OCTREOTIDE; SOMATOSTATIN; VASOCONSTRICTOR AGENTS; VASOPRESSINS;

EID: 40749135917     PISSN: 15216918     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.bpg.2007.11.001     Document Type: Article

References (93)

1. Armonis A., Patch D., and Burroughs A.K. Hepatic venous pressure measurement: an old test as new prognostic marker in cirrhosis?. Hepatology 25 (1997) 245-248
2. Merkel C., and Gatta A. Can we predict the first variceal bleeding in the individual patient with cirrhosis and esophageal varices. J Hepatol 13 (1991) 378
3. Levacher S., Letoumelin P., Pateron D., et al. Early administration of terlipressin plus glyceryl trinitrate to control active upper gastrointestinal bleeding in cirrhotic patients. Lancet 346 (1995) 865-868
4. Avgerinos A., Nevens F., Raptis S., et al. Early administration of somatostatin and efficacy of sclerotherapy in acute oesophageal variceal bleeds: the European Acute Bleeding Oesophageal Variceal Episodes (ABOVE) randomised trial. Lancet 350 (1997) 1495-1499
5. Bañares R., Albillos A., Rincon D., et al. Endoscopic treatment versus endoscopic plus pharmacologic treatment for acute variceal bleeding: a meta-analysis. Hepatology 35 (2002) 609-615
6. de Franchis R. Evolving Consensus in Portal Hypertension Report of the Baveno IV Consensus Workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol 43 (2005) 167-176
7. Nidegger D., Ragot S., Berthelemy P., et al. Cirrhosis and bleeding: the need for very early management. J Hepatol 39 4 (2003) 509-514
8. Fort E., Sauterau D., Silvaine C., et al. A randomized trial of terlipressin plus nitroglycerin vs ballon tamponade in the control of acute variceal haemorrhage. Hepatology 11 (1990) 678-681
9. Abraldes J.G., and Bosch J. Somatostatin and analogues in portal hypertension. Hepatology 35 (2002) 1305-1312
10. D'Amico G., Pagliaro L., and Bosch J. Pharmacological treatment of portal hypertension: an evidence-based approach. Semin Liver Dis 19 (1999) 475-505
11. D'Amico G., Pagliaro L., and Bosch J. The treatment of portal hypertension: a meta-analytic review. Hepatology 22 (1995) 332-354
12. Bosch J., Groszmann R.J., Garcia-Pagan J.C., et al. Association of transdermal nitroglycerin to vasopressin infusion in the treatment of variceal hemorrhage: a placebo-controlled clinical trial. Hepatology 10 6 (1989) 962-968
13. Bosch J., and Garcia-Pagan J.C. Complications of cirrhosis. I. Portal hypertension. J Hepatol 32 Suppl 1 (2000) 141-156
14. Bathal P.S., and Grossmann H.J. Reduction of the increased portal vascular resistance of the isolated perfused cirrhotic rat liver by vasodilators. J Hepatol 1 (1985) 325-329
15. Bosch J., Lebrec D., and Jenkins S.A. Development of analogues: successes and failures. Scand J Gastroenterol Suppl 226 (1998) 3-13
16. Escorsell A., Ruiz dA., Planas R., et al. Multicenter randomized controlled trial of terlipressin versus sclerotherapy in the treatment of acute variceal bleeding: the TEST study. Hepatology 32 3 (2000) 471-476
17. Ioannou G., Doust J., and Rockey D.C. Terlipressin for acute esophageal variceal hemorrhage (Cochrane Review). Cochrane Database Syst Rev 1 (2001) CD002147
18. Feu F., Ruiz del Arbol L., Banares R., et al. Double-blind randomized controlled trial comparing terlipressin and somatostatin for acute variceal hemorrhage. Variceal Bleeding Study Group. Gastroenterology 111 (1996) 1291-1299
19. Escorsell A., Bandi J.C., Moitinho E., et al. Time profile of the haemodynamic effects of terlipressin in portal hypertension. J Hepatol 26 3 (1997) 621-627
20. Moreau R., Durand F., Poynard T., et al. Terlipressin in patients with cirrhosis and type 1 hepatorenal syndrome: a retrospective multicenter study. Gastroenterology 122 4 (2002) 923-930
21. Ioannou G.N., Doust J., and Rockey D.C. Systematic review: terlipressin in acute oesophageal variceal haemorrhage. Aliment Pharmacol Ther 17 (2003) 53-64
22. McAuley D., and Jaffer U. Best evidence topic report. Terlipressin or sclerotherapy for acute variceal bleeding?. Emergency Medicine Journal 23 4 (2006 Apr) 301
23. Cirera I., Feu F., Luca A., et al. Effects of bolus injections and continuous infusions of somatostatin and placebo in patients with cirrhosis: a double-blind hemodynamic investigation. Hepatology 22 (1995) 106-111
24. Bosch J., Kravetz D., and Rodes J. Effects of somatostatin on hepatic and systemic hemodynamics in patients with cirrhosis of the liver: comparison with vasopressin. Gastroenterology 80 (1981) 518-525
25. Escorsell A., Bordas J.M., Ruiz del Arbol L., et al. Randomized controlled trial of sclerotherapy versus somatostatin infusion in the prevention of early rebleeding following acute variceal hemorrhage in patients with cirrhosis. Variceal Bleeding Study Group. J Hepatol 29 (1998) 779-788
26. Moitinho E., Planas R., Bañares R., et al. Multicenter randomized controlled trial comparing different schedules of somatostatin in the treatment of acute variceal bleeding. J Hepatol 35 (2001) 712-718
27. Escorsell A., Bandi J.C., Andreu V., et al. Desensitization to the effects of intravenous octreotide in cirrhotic patients with portal hypertension. Gastroenterology 120 (2001) 161-169
28. Corley D.A., Cello J.P., Adkisson W., et al. Octreotide for acute esophageal variceal bleeding: a meta-analysis. Gastroenterology 120 (2001) 946-954
29. Burroughs A.K., and International Octreotide Varices Study Group. Double blind RCT of 5 day octreotide versus placebo, associated with sclerotherapy for trial failures. Hepatology 24 (1996) 352A
30. Morales G.F., Pereira Lima J.C., Hornos A.P., et al. Octreotide for esophageal variceal bleeding treated with endoscopic sclerotheraphy: a randomized, placebo - controlled trial. Hepatogastroenterology 54 73 (2007) 195-200
31. Bosch J., Kravetz D., Mastai R., et al. Effects of somatostatin in patients with portal hypertension. Horm Res 29 2-3 (1988) 99-102
32. Soares-Weiser K., Brezis M., Tur-Kaspa R., et al. Antibiotic prophylaxis for cirrhotic patients with gastrointestinal bleeding. Cochrane Database Syst Rev 2 (2002) CD002907
33. Deschenes M., and Villeneuve J.O. Risk factors for the development of bacterial infections in hospitalised patients with cirrhosis. Am J Gastroenterol 94 8 (1999) 2193-2197
34. Bernard B., Grange J.D., Khac E.N., et al. Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: a meta-analysis. Hepatology 29 6 (1999) 1655-1661
35. Rimola A., Garcia-Tsao G., Navasa M., et al. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club. J Hepatol 32 1 (2000) 142-153
36. Fernandez J., Ruiz del Arbol L., Gomez C., et al. Norfloxacin versus ceftriaxone in the prophylaxis of infections in patients with advanced cirrhosis and hemorrhage. Gastroenterology 131 4 (2006) 1049-1056
37. de Franchis R., Arcidiacono P.G., Carpinelli L., et al. Randomized controlled trial of desmopressin plus terlipressin versus terlipressin alone for the treatment of acute variceal hemorrhage in cirrhotic patients: a multicenter, double-blind study. New Italian Endoscopic Club. Hepatology 18 5 (1993) 1102-1107
38. Smith O., Hazlehurst G., Brozovic B., et al. Impact of aprotinin on blood transfusion requirements in liver transplantation. Transfus Med 3 2 (1993) 97-102
39. Bosch J., Thabut D., Bendtsen F., et al. Recombinant factor VIIa for upper gastrointestinal bleeding in patients with cirrhosis: a randomised, double-blind trial. Gastroenterology 127 4 (2004) 1123-1130
40. Bosch J., Thabut D., Albillos A., et al. Recombinant factor VIIa (RFVIIA) for active variceal bleeding in patients with advanced cirrhosis: a multi-centre randomized double-blind placebo-controlled trial. J Hepatol 46 Suppl 1 (2007) S295
41. North Italian Endoscopic Club. Prediction of the 1st variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices - a prospective multicenter study. N Engl J Med 319 (1988) 983-989
42. de Franchis R., Pascal J.P., Ancona E., et al. Definitions, methodology and therapeutic strategies in portal hypertension. A Consensus Development Workshop, Baveno, Lake Maggiore, Italy. April 5 and 6, 1990. J Hepatol 15 (1992) 256-261
43. Lebrec D., Nouel O., Bernuau J., et al. Propranolol in prevention of recurrent gastrointestinal bleeding in cirrhotic patients. Lancet 1 8226 (1981) 920-921
44. Lebrec D., Hillon P., Munoz C., et al. The effect of propranolol on portal hypertension in patients with cirrhosis: a hemodynamic study. Hepatology 2 5 (1982) 523-527
45. Bernard B., Lebrec D., Mathurin P., et al. Beta-adrenergic antagonists in the prevention of gastrointestinal rebleeding in patients with cirrhosis: a meta-analysis. Hepatology 25 (1997) 63-70
46. Bolognesi M., Balducci G., Garcia-Tsao G., et al. Complications of the medical treatment of portal hypertension. In: de Franchis R. (Ed). Portal Hypertension III, Proceedings of the Third Baveno International Consensus Workshop on Definitions, Methodology and Therapeutic Strategies (2001), Blackwell Science, Oxford, UK 180-203
47. de Franchis R. Updating consensus in portal hypertension: report of the Baveno III Consensus Workshop on definitions, methodology and therapeutic strategies in portal hypertension. J Hepatol 33 5 (2000) 846-852
48. Feu F., Garcia-Pagàn J.C., Bosch J., et al. Relation between portal pressure response to pharmacotherapy and risk of recurrent variceal haemorrhage in patients with cirrhosis. Lancet 346 (1995) 1056-1059
49. Groszmann R.J., Bosch J., Grace N.D., et al. Hemodynamic events in a prospective randomized trial of propranolol versus placebo in the prevention of a first variceal hemorrhage. Gastroenterology 99 5 (1990) 1401-1407
50. Conn H.O., Grace N.D., Bosch J., et al. Propranolol in the prevention of the first hemorrhage from esophagogastric varices: a multicenter, randomized clinical trial. The Boston-New Haven-Barcelona Portal Hypertension Study Group. Hepatology 13 5 (1991) 902-912
51. Abraczinskas D.R., Ookubo R., Grace N.D., et al. Propranolol for the prevention of first esophageal variceal hemorrhage: a lifetime commitment?. Hepatology 34 (2001) 1096-1102
52. Lebrec D., Nouel O., Corbic M., et al. Propranolol-a medical treatment for portal hypertension?. Lancet 2 8187 (1980) 180-182
53. Poynard T., Cales P., Pasta L., et al. Beta-adrenergic-antagonist drugs in the prevention of gastrointestinal bleeding in patients with cirrhosis and esophageal varices. An analysis of data and prognostic factors in 589 patients from four randomized clinical trials. Franco-Italian Multicenter Study Group. N Engl J Med 324 22 (1991) 1532-1538
54. Pagliaro L., D'Amico G., Sorensen T.I., et al. Prevention of first bleeding in cirrhosis. A meta-analysis of randomized trials of nonsurgical treatment. Ann Intern Med 117 1 (1992) 59-70
55. Groszmann R.J., Garcia-Tsao G., Bosch J., et al. Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis. N Engl J Med 353 (2005) 2254-2261
56. Lebrec D., Poynard T., Hillon P., et al. Propranolol for prevention of recurrent gastrointestinal bleeidng in patients with cirrhosis. N Engl J Med 305 (1981) 1371-1374
57. Burroughs A.K., Jenkins W.J., Sherlock S., et al. Controlled trial of propranolol for the prevention of recurrent variceal hemorrhage in patients with cirrhosis. N Engl J Med 25 (1983) 1539-1542
58. Villeneuve J.P., Pomier-Layrargues G., Infante-Rivard C., et al. Propranolol for the prevention of recurrent variceal hemorrhage: a controlled trial. Hepatology 6 (1986) 1239-1243
59. Colombo M., de Franchis R., Tommasini M., et al. Beta-blockade prevents recurrent gastrointestinal bleeding in well compensated patients with alcoholic cirrhosis: a multicenter randomised controlled trial. Hepatology 9 (1989) 433-438
60. Colman J., Jones P., Finch C., et al. Propranolol in the prevention of variceal haemorrhage in alcoholic cirrhotic patients (abstract). Hepatology 12 (1990) 851
61. Garden O.J., Mills P.R., Birnie G.G., et al. Propranolol in the prevention of recurrent variceal haemorrhage in cirrhotic patients. Gastroenterology 98 (1990) 185-190
62. Rossi V., Cales P., Burtin P., et al. Prevention of recurrent variceal bleeding in alcoholic cirrhotic patients: prospective controlled trial of propranolol and sclerotherapy. J Hepatol 12 (1991) 283-289
63. Bernard B., Lebrec D., Mathurin P., et al. Propranolol and sclerotherapy in the prevention of gastrointestinal rebleeding in patients with cirrhosis. A meta-analysis. J Hepatol 26 (1997) 312-324
64. Garcia-Pagan J.C., Escorsell A., Moitinho E., et al. Influence of pharmacological agents on portal hemodynamics: Basis for its use in the treatment of portal hypertension. Semin Liver Dis 19 (1999) 427-438
65. Garcia Pagan J.C., Villanueva C., Vila M.C., et al. Isosorbide mononitrate in the prevention of first bleed in patients who cannot receive beta-blockers. Gastroenterology 121 (2001) 908-914
66. Groszmann R.J. Beta-adrenergic blockers and nitrovasodilators for the treatment of portal hypertension: the good, the bad, the ugly. Gastroenterology 113 5 (1997) 1794-1797
67. Angelico M., Carli L., Piat C., et al. Effects of isosorbide-5-mononitrate compared with propranolol on first bleeding and long-term survival in cirrhosis. Gastroenterology 113 (1997) 1632-1639
68. Borroni G., Salerno F., Cazzaniga M., et al. Nadolol is superior to isosorbide mononitrate for the prevention of the first variceal bleeding in cirrhotic patients with ascites. J Hepatol 37 3 (2002) 315-321
69. Lui H.F., Stanley A.J., Forrest E.H., et al. Primary prophylaxis of variceal hemorrhage: a randomized controlled trial comparing band ligation, propranolol, and isosorbide mononitrate. Gastroenterology 123 3 (2002) 735-744
70. Morillas R.M., Planas R., Cabre E., et al. Propranolol plus isosorbide-5-mononitrate for portal hypertension in cirrhosis: long-term hemodynamic and renal effects. Hepatology 20 6 (1994) 1502-1508
71. Albillos A., Lledo J.L., Rossi I., et al. Continuous prazosin administration in cirrhotic patients: effects on portal hemodynamics and on liver and renal function. Gastroenterology 109 4 (1995) 1257-1265
72. Albillos A., Garcia-Pagan J.C., Iborra J., et al. Propranolol plus prazosin compared with propranolol plus isosorbide-5-mononitrate in the treatment of portal hypertension. Gastroenterology 115 1 (1998) 116-123
73. Garcia-Pagan J.C., Feu F., Bosch J., et al. Propranolol compared with propranolol plus isosorbide-5-mononitrate for portal hypertension in cirrhosis. A randomized controlled study. Ann Intern Med 114 10 (1991) 869-873
74. Merkel C., Marin R., Enzo E., et al. Randomised trial of nadolol alone or with isosorbide mononitrate for primary prophylaxis of variceal bleeding in cirrhosis. Gruppo-Triveneto per L'ipertensione portale (GTIP). Lancet 348 (1996) 1677-1681
75. Pietrosi G., D'Amico G., Pasta L., et al. Isosorbide mononitrate (IMN) with nadolol compared to nadolol alone for prevention of first bleeding in cirrhosis: a double blind placebo-controlled randomised trial. J Hepatol 30 Suppl 1 (1999) 66 (abstract)
76. Garcia-Pagan J.C., Morillas S., Bañares R., et al. Propranolol + placebo versus Propranolol + isosorbide-5-mononitrate in the prevention of the first variceal bleed. A double blind RCT. Hepatology 37 (2003) 1260-1266
77. Garcia-Pagan J.C., and Grace N.D. Primary prophylaxis. In: de Franchis R. (Ed). Proceedings of the Third Baveno International Consensus Workshop on Definitions, Methodology and Therapeutic Strategies (2001), Blackwell Science 127-133
78. Gournay J., Masliah C., Martin T., et al. Isosorbide mononitrate and propranolol compared with propranolol alone for the prevention of variceal rebleeding. Hepatology 31 6 (2000) 1239-1245
79. Patti R., Pasta L., D'Amico G., et al. Isosorbide mononitrate with nadolol compared to nadolol alone for prevention of recurrent bleeding in cirrhosis. A double blind placebo-controlled randomised trial. Final report. J Hepatol 34 Suppl 1 (2001) 63 (664a)
80. Villanueva C., Balanzo J., Novella M.T., et al. Nadolol plus isosorbide mononitrate compared with sclerotherapy for the prevention of variceal rebleeding. N Engl J Med 334 25 (1996) 1624-1629
81. Villanueva C., Miñana J., Ortiz J., et al. Endoscopic ligation compared with nadolol and isosorbide mononitrate to prevent recurrent variceal bleeding. N Engl J Med 345 (2002) 647-655
82. Lo G.H., Chen W.C., Chen M.H., et al. Banding ligation versus nadolol and isosorbide mononitrate for the prevention of esophageal variceal rebleeding. Gastroenterology 123 (2002) 728-734
83. Patch D., Sabin C.A., Goulis J., et al. A randomized, controlled trial of medical therapy versus endoscopic ligation for the prevention of variceal rebleeding in patients with cirrhosis. Gastroenterology 123 (2002) 1013-1019
84. Romero G., Kravetz D., Argonz J., et al. Comparative study between nadolol and 5-isosorbide mononitrate versus endoscopic band ligation plus sclerotherapy in the prevention of variceal rebleeding in cirrhotic patients: a randomized controlled trial. Alimentary Pharmacol Ther 24 4 (2006) 601-611
85. Escorsell A., and Garcia Pagan J.C. TIPS in the prevention of variceal rebleeding. Results of randomized controlled trials. In: Arroyo V., Bosch J., Bruguera M., Rodes J., and Sanchez Tapias J.M. (Eds). Treatments in Hepatology (1999), Masson, Barcelona 25-30
86. Bañares R., Moitinho E., Matilla A., et al. Randomised comparison of long term carvedilol and propranolol administration in the treatment of portal hypertension in cirrhosis. Hepatology 36 (2002) 1367-1373
87. Garcia-Pagan J.C., Salmeron J.M., Feu F., et al. Effects of low-sodium diet and spironolactone on portal pressure in patients with compensated cirrhosis. Hepatology 19 5 (1994) 1095-1099
88. Abecasis R., Kravetz D., Fassio E., et al. Nadolol plus spironalctone in the prophylaxis of first variceal bleed in nonascitic cirrhotic patients: a preliminary study. Hepatology 37 (2003) 359-365
89. Schneider A.W., Friedrich J., and Klein C.P. Effect of losartan, an angiotensin II receptor antagonist, on portal pressure in cirrhosis. Hepatology 29 (1999) 334-339
90. Gonzalez-Abraldes J., Albillos A., Banares R., et al. Randomized comparison of long-term losartan versus propranolol in lowering portal pressure in cirrhosis. Gastroenterology 121 2 (2001) 382-388
91. Schepke M., Werner E., Biecker E., et al. Haemodynamic effect of the angiotensin II receptor antagonist irbesartan in patients with cirrhosis and portal hypertension. Gastroenterology 121 (2001) 389-395
92. De Bernardi Venon W., Baronio M., Leone N., et al. Effects of long term irbesartan in reducing portal pressure in cirrhotic patients: comparison with propranolol in a randomised controlled study. J Hepatol 38 (2003) 455-460
93. De B.K., Bandyopadhyay K., Das T.K., et al. Portal pressure response to losartan compared with propranolol in patients with cirrhosis. Am J Gastroenterol 98 (2003) 1371-1376