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Controlled trial of ligation plus nadolol versus nadolol alone for the prevention of first variceal bleeding.
Hepatology. 2010 Jul; 52(1):230-7.Hep

Abstract

Both nadolol and ligation have proved to be effective in the prophylaxis of first variceal bleeding. This study was conducted to evaluate the effects and safety of combining nadolol with ligation. Cirrhotic patients with high-risk esophageal varices but without a bleeding history were considered for enrolment. Eligible patients were randomized to receive band ligation plus nadolol (Combined group, 70 patients) or nadolol alone (Nadolol group, 70 patients). In the Combined group multiligators were applied. Patients received regular ligation treatment at an interval of 4 weeks until variceal obliteration. Nadolol was administered at a dose to reduce 25% of the pulse rate in both the Combined group and the Nadolol group. Both groups were comparable in baseline data. In the Combined group 50 patients (71%) achieved variceal obliteration. The mean dose of nadolol was 52 +/- 16 mg in the Combined group and 56 +/- 19 mg in the Nadolol group. During a median follow-up of 26 months, 18 patients (26%) in the Combined group and 13 patients (18%) in the Nadolol group experienced upper gastrointestinal bleeding (P = NS). Esophageal variceal bleeding occurred in 10 patients (14%) in the Combined group and nine patients (13%) in the Nadolol group (P = NS). Adverse events were noted in 48 patients (68%) in the Combined group and 28 patients (40%) in the Nadolol group (P = 0.06). Sixteen patients in each group died.

CONCLUSION

The addition of ligation to nadolol may increase adverse events and did not enhance effectiveness in the prophylaxis of first variceal bleeding.

Authors+Show Affiliations

Department of Medical Education, Digestive Center, E-DA Hospital, Kaohsiung, Taiwan. ghlo@kimo.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

20578138

Citation

Lo, Gin-Ho, et al. "Controlled Trial of Ligation Plus Nadolol Versus Nadolol Alone for the Prevention of First Variceal Bleeding." Hepatology (Baltimore, Md.), vol. 52, no. 1, 2010, pp. 230-7.
Lo GH, Chen WC, Wang HM, et al. Controlled trial of ligation plus nadolol versus nadolol alone for the prevention of first variceal bleeding. Hepatology. 2010;52(1):230-7.
Lo, G. H., Chen, W. C., Wang, H. M., & Lee, C. C. (2010). Controlled trial of ligation plus nadolol versus nadolol alone for the prevention of first variceal bleeding. Hepatology (Baltimore, Md.), 52(1), 230-7. https://doi.org/10.1002/hep.23617
Lo GH, et al. Controlled Trial of Ligation Plus Nadolol Versus Nadolol Alone for the Prevention of First Variceal Bleeding. Hepatology. 2010;52(1):230-7. PubMed PMID: 20578138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Controlled trial of ligation plus nadolol versus nadolol alone for the prevention of first variceal bleeding. AU - Lo,Gin-Ho, AU - Chen,Wen-Chi, AU - Wang,Huay-Min, AU - Lee,Ching-Chang, PY - 2010/6/26/entrez PY - 2010/6/26/pubmed PY - 2010/7/20/medline SP - 230 EP - 7 JF - Hepatology (Baltimore, Md.) JO - Hepatology VL - 52 IS - 1 N2 - UNLABELLED: Both nadolol and ligation have proved to be effective in the prophylaxis of first variceal bleeding. This study was conducted to evaluate the effects and safety of combining nadolol with ligation. Cirrhotic patients with high-risk esophageal varices but without a bleeding history were considered for enrolment. Eligible patients were randomized to receive band ligation plus nadolol (Combined group, 70 patients) or nadolol alone (Nadolol group, 70 patients). In the Combined group multiligators were applied. Patients received regular ligation treatment at an interval of 4 weeks until variceal obliteration. Nadolol was administered at a dose to reduce 25% of the pulse rate in both the Combined group and the Nadolol group. Both groups were comparable in baseline data. In the Combined group 50 patients (71%) achieved variceal obliteration. The mean dose of nadolol was 52 +/- 16 mg in the Combined group and 56 +/- 19 mg in the Nadolol group. During a median follow-up of 26 months, 18 patients (26%) in the Combined group and 13 patients (18%) in the Nadolol group experienced upper gastrointestinal bleeding (P = NS). Esophageal variceal bleeding occurred in 10 patients (14%) in the Combined group and nine patients (13%) in the Nadolol group (P = NS). Adverse events were noted in 48 patients (68%) in the Combined group and 28 patients (40%) in the Nadolol group (P = 0.06). Sixteen patients in each group died. CONCLUSION: The addition of ligation to nadolol may increase adverse events and did not enhance effectiveness in the prophylaxis of first variceal bleeding. SN - 1527-3350 UR - https://www.unboundmedicine.com/medline/citation/20578138/Controlled_trial_of_ligation_plus_nadolol_versus_nadolol_alone_for_the_prevention_of_first_variceal_bleeding_ L2 - https://doi.org/10.1002/hep.23617 DB - PRIME DP - Unbound Medicine ER -