CIRRHOSIS Clinical Trial
Official title:
PROPRANOLOL ASSOCIATED WITH ENDOSCOPIC BAND LIGATION REDUCES RECURRENCE OF ESOPHAGEAL VARICES FOR PRIMARY PROPHYLAXIS OF VARICEAL BLEEDING?: A RANDOMIZED CONTROLLED TRIAL
This prospective randomized controlled trial will compare endoscopic band ligation (EBL) with propranolol and EBL alone in primary prophylaxis of variceal bleeding among cirrhotic patients with high-risk varices.
BACKGROUND AND AIMS
Bleeding from esophagogastric varices (EV) is a major complication of portal hypertension.
Beta-blockers are a well-established cornerstone of portal hypertension treatment. Band
ligation is the best endoscopic treatment to prevent EV bleeding. The exact benefit of
beta-blocker association to band ligation remains to be defined, especially for primary
prophylaxis. This prospective randomized controlled trial will compare EBL with propranolol
and EBL alone in primary prophylaxis of variceal bleeding among cirrhotic patients with
high-risk varices. PATIENTS AND METHODS: The patients with high-risk varices will be
randomly allocated to EBL plus propranolol (Group I) or EBL alone (Group II). EBL will be
performed at 3-week interval till obliteration of varices. In Group I, incremental dosage of
propranolol (sufficient to reduce heart rate to 55 beats/min or 25% reduction from baseline)
will be administered and will be continued after obliteration of varices until the end of
the study. The follow-up of patients will be 2 years. The primary outcome of this study will
be EV recurrence during two years of follow-up. The secondary outcomes will be EV
eradication, bleeding before eradication, mortality and complications during the same
follow-up.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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