Systematic review with meta-analysis: The haemodynamic effects of carvedilol compared with propranolol for portal hypertension in cirrhosis

Alimentary Pharmacology and Therapeutics

Volumn 39, Issue 6, 2014, Pages 557-568

  Sinagra, E ^b,d   Perricone, G ^b,c   D'Amico, M ^e   Tine F ^a   D'Amico, G ^a  

^a Ospedali Riuniti Villa Sofia Cervello   (Italy)

^b Ospedali Riuniti Villa Sofia Vincenzo Cervello   (Italy)

^c OSPEDALE NIGUARDA CA GRANDA   (Italy)

^d Fondazione Istituto San Raffaele Giglio   (Italy)

^e UNIVERSITY OF PALERMO   (Italy)

Author keywords

[No Author keywords available]

Indexed keywords

CARVEDILOL; PROPRANOLOL;

BLEEDING; CONTINUOUS INFUSION; DRUG EFFICACY; DRUG INDICATION; DRUG MECHANISM; DRUG SAFETY; DRUG WITHDRAWAL; DYSPNEA; ESOPHAGUS VARICES; HEMODYNAMICS; HEPATIC ENCEPHALOPATHY; HUMAN; HYPOTENSION; LIVER CIRRHOSIS; LIVER FAILURE; LIVER VEIN; META ANALYSIS; ORTHOSTATIC HYPOTENSION; OUTCOMES RESEARCH; PORTAL HYPERTENSION; PRESSURE GRADIENT; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; RISK FACTOR; SYSTEMATIC REVIEW; TREATMENT DURATION; VARICOSIS;

ADRENERGIC BETA-ANTAGONISTS; CARBAZOLES; HEMODYNAMICS; HEPATIC VEINS; HUMANS; HYPERTENSION, PORTAL; LIVER CIRRHOSIS; PROPANOLAMINES; PROPRANOLOL;

EID: 84894521990     PISSN: 02692813     EISSN: 13652036     Source Type: Journal    
DOI: 10.1111/apt.12634     Document Type: Review

References (29)

1. Bosch J, Berzigotti A, Garcia-pagan JC, Abraldes JG,. The management of portal hypertension: rational basis, available treatments and future options. J Hepatol 2008; 48 (Suppl. 1): S68-92.
2. D'Amico G, Luca A,. Natural history. Clinical-haemodynamic correlations. Prediction of the risk of bleeding. Baillieres Clin Gastroenterol 1997; 11: 243-56.
3. Groszmann RJ, Bosch J, Grace ND, et al,. Hemodynamic events in a prospective randomized trial of propanolol versus placebo in the prevention of a first variceal hemorrhage. Gastroenterology 1990; 99: 1401-7.
4. Ripoll C, Groszmann R, Garcia-Tsao G, et al. Portal Hypertension Collaborative Group. Hepatic venous pressure gradient predict clinical decompensation in patients with compensated cirrhosis. Gastroenterology 2007; 133: 481-8.
5. Ripoll C, Groszmann R, Garcia-Tsao G, et al. Portal Hypertension Collaborative Group. Hepatic venous pressure gradient predicts development of hepatocellular carcinoma independently of severity of cirrhosis. J Hepatol 2009; 50: 923-8.
6. Feu F, Garcia Pagan JC, Bosch J, et al,. Relation between portal pressure response to pharmacotherapy and risk of recurrent variceal hemorrhage in patients with cirrhosis. Lancet 1995; 346: 1056-9.
7. Vorobioff J, Picabea E, Villavicencio R, et al,. Acute and chronic hemodynamic effects of propranolol in unselected cirrhotic patients. Hepatology 1987; 7: 648-53.
8. Lebrec D, Hillon P, Munoz C, Goldfarb G, Nouel O, Benhamou JP,. The effect of propranolol on portal hypertension in patients with cirrhosis: a hemodynamic study. Hepatology 1982; 2: 523-7.
9. Kroeger RJ, Groszmann RJ,. Increased portal venous resistance hinders portal pressure reduction during the administration of beta-adrenergic blocking agents in a portal hypertensive model. Hepatology 1985; 5: 97-101.
10. Garcia-Pagán JC, Navasa M, Bosch J, Bru C, Pizcueta P, Rodés J,. Enhancement of portal pressure reduction by the association of isosorbide-5-mononitrate to propranolol administration in patients with cirrhosis. Hepatology 1990 Feb; 11: 230-8.
11. Tripathi D, Hayes P,. The role of carvedilol in the management of portal hypertension. Eur J Gastroenterol Hepatol 2010; 22: 905-11.
12. D'Amico G, Garcia-Tsao G, Calès P, et al,. Diagnosis of Portal Hypertension: how and when. In:, de Franchis R, ed. Proceedings of the third Baveno International Consensus Workshop on definitions, methodology and therapeutic strategies. Oxford, UK: Blackwell Science, 2001; 36-64.
13. Garcia-Tsao G, D'Amico G, Abraldes J, et al,. Prognostic indicators in cirrhosis. In:, de Franchis R, ed. Portal Hypertension IV. Oxford: Proceedings of the fourth Baveno International Consensus Workshop on Methodology of Diagnosis and Treatment. Blackwell, 2006; 47-100.
14. Feu F, Garcia-Pagan JC, Bosch J, et al,. Relation between portal pressure response to pharmacotherapy and risk of recurrent variceal haemorrhage in patients with cirrhosis. Lancet 1995; 346: 1056-9.
15. Kjaergard LL, Villumsen J, Gluud C,. Reported methodological quality and discrepancies between large and small randomised trials in meta-analyses. Ann Intern Med 2001; 135: 982-9.
16. Gluud LL,. Bias in clinical intervention research. Am J Epidemiol 2006; 163: 493-501.
17. Higgins JPT, Thompson SG, Deeks JJ, Altman DG,. Measuring inconsistency in metaanalyses. BMJ 2003; 327: 557-60.
18. Tripathi D, Ferguson JW, Kochar N, et al,. Randomized controlled trial of carvedilol versus variceal band ligation for the prevention of the first variceal bleed. Hepatology 2009; 50: 825-33.
19. Lo GH, Chen WC, Wang HM, Yu HC,. Randomized controlled trial of carvedilol versus nadolol plus isosorbide mononitrate for the prevention of variceal rebleeding. J Gastroenterol Hepatol 2012; 27: 1681-7.
20. Hobolth L, Moeller S, Groenbaek H, Keiding S, Bendtsen F, Feldager E,. Carvedilol or propranolol in portal hypertension? A randomized controlled trial J Hepatol 2010; 52: s59-182.
21. Banares R, Moitinho E, Piqueras B, et al,. Carvedilol, a new nonselective beta-blocker with intrinsic anti- Alpha1-adrenergic activity, has a greater portal hypotensive effect than propranolol in patients with cirrhosis. Hepatology 1999; 30: 79-83.
22. Banares R, Moitinho E, Matilla A, et al,. Randomized comparison of long-term carvedilol and propanolol administration in the treatment of portal hypertension in cirrhosis. Hepatology 2002; 36: 1367-73.
23. De BK, Das D, Sen S, et al,. Acute and 7-day portal pressure response to carvedilol and propranolol in cirrhotics. J Gastroenterol Hepatol 2002; 17: 183-9.
24. Lin HC, Yang YY, Hou MC, Huang YT, Lee FY, Lee SD,. Acute administration of carvedilol is more effective than propranolol plus isosorbide-5-mononitrate in the reduction of portal pressure in patients with viral cirrhosis. Am J Gastroenterol 2004; 99: 1953-8.
25. Hobolth L, Bendtsen F, Hansen EF, Moller S,. Effects of carvedilol and propranolol on circulatory regulation and oxygenation in cirrhosis: a randomized study. Dig Liv Dis 2013; doi: 10.1016/j.dld.2013.10.013 [Epub ahead of print].
26. Hobolth L, Moller S, Gronbaek H, Roelsgaard K, Bendtsen F, Hansen EF,. Carvedilol or propranolol in portal hypertension? A randomized comparison Scand J Gastroenterol 2012; 47: 467-74.
27. Albillos A, Garcia-Pagàn JC, Iborra J, et al,. Propranolol plus prazosin compared with propranolol plus isosorbide-5-mononitrate in the treatment of portal hypertension. Gastroenterology 1998; 115: 116-23.
28. Reiberger T, Ulbrich G, Ferlitsch A, et al,. Carvedilol for primary prophylaxis of variceal bleeding in cirrhotic patients with haemodynamic non-response to propranolol. Gut 2013; 62: 1634-41.
29. Egger M, Smith DG, Schneider M, Minder C,. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629-34.